标准一线化疗联用贝伐珠单抗在晚期非小细胞肺癌患者治疗中的成本-效果分析

目的从我国现阶段医疗卫生角度出发,评价四川地区一线化疗联用贝伐珠单抗治疗晚期非小细胞癌的成本-效果性。方法依据NCT00021060临床试验数据,结合四川地区医疗费用水平,采用成本-效果分析法,以增量成本-效果比为评价指标,评价标准一线化疗联用贝伐珠单抗在晚期非小细胞癌治疗方案的优劣,并分析结果敏感度。结果与标准一线化疗组相比,贝伐珠单抗组ICER为1 909 117.8元/年;敏感度分析结果提示,贝伐珠单抗使用成本和医疗检查成本对总成本影响最大,其他参数影响较小。结论从我国现阶段医疗卫生角度出发,与标准一线化疗相比,四川地区晚期非小细胞肺癌一线化疗联用贝伐珠单抗,不具有成本效果优势。

Cost-effectiveness of first-line chemotherapy with bevacizumab for patients with advanced non-small-cell lung cancer

Objective To evaluate the cost-effectiveness of first-line chemotherapy with bevacizumab for patients with advanced non-small-cell lung cancer （NSCLC） from the perspective of Chinese health care system. Methods According to the clinical data of NCT00021060, we used the cost-effectiveness analysis （CEA） to estimate the cost- effectiveness of first-line chemotherapy with bevacizumab for patients with advanced NSCLC by the incremental cost effectiveness ratios （ICER） in Sichuan province. Sensitivity analysis was performed to assess the stability. Results Compared with first-line chemotherapy, ICER of the bevacizumab group was RMB 1 909 117.8 per year. The sensitiv- ity analysis indicated that the cost of bevacizumab and the medical examination fee had the greatest influence on the total cost among all parameters. Conclusion Bevacizumab in combination with first-line chemotherapy may not be a cost-effective option in advanced NSCLC from the perspective of Chinese health care system at present.