本文選題：結(jié)直腸癌 + 化療方案　； 參考：《中國(guó)醫(yī)院藥學(xué)雜志》2017年22期

【摘要】：目的:探討轉(zhuǎn)移性結(jié)直腸癌(mCRC)3種一線化療方案的藥物經(jīng)濟(jì)學(xué)效果及影響因素。方法:采用回顧性調(diào)查方法,納入2012年1月1日-2015年10月30日期間符合納入標(biāo)準(zhǔn)的mCRC患者,根據(jù)化療方案不同分為FOLFOX組、CapeOx組和FOLFIRI組。以總住院費(fèi)用為成本,無(wú)進(jìn)展生存時(shí)間(PFS)為效果,對(duì)3種化療方案進(jìn)行成本-效果分析和敏感度分析,并評(píng)價(jià)化療藥物是否國(guó)產(chǎn)及醫(yī)保支付對(duì)結(jié)果的影響。結(jié)果:共納入678名患者,FOLFOX組(136例)、CapeOx組(392例)和FOLFIRI組(150例)間基本情況無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),具有可比性。FOLFOX組、CapeOx組和FOLFIRI組PFS分別為154.15 d、156.16 d和165.84 d,不良反應(yīng)各組間無(wú)統(tǒng)計(jì)學(xué)差異,總治療費(fèi)用分別為63 956.11元、73 826.06元和79 259.20元,成本-效果比分別為414.90、472.76和477.93。在FOLFOX方案的基礎(chǔ)上,每增加一天PFS,FOLFIRI方案和CapeOx方案所追加的成本分別為57.86元和59.69元。敏感度分析結(jié)果與成本-效果分析一致。亞組分析表明,國(guó)產(chǎn)藥物的效果略低于進(jìn)口藥物,成本均高于進(jìn)口藥物,成本-效果比低于進(jìn)口藥物,藥物經(jīng)濟(jì)學(xué)效果好。3種方案患者自付費(fèi)用成本-效果比FOLFOX方案CapeOx方案FOLFIRI方案,醫(yī)保支付費(fèi)用成本-效果比FOLFOXFOLFIRICapeOx。結(jié)論:mCRC3種一線化療方案中,成本最低的為FOLFOX方案,效果最佳的為FOLFIRI方案,經(jīng)濟(jì)學(xué)效果最優(yōu)為FOLFOX方案。
[Abstract]:Objective: to investigate the pharmacoeconomic effects and influencing factors of three first-line chemotherapy regimens for metastatic colorectal cancer (mCRC). Methods: according to the chemotherapy regimen, mCRC patients who met the inclusion criteria from January 1, 2012 to October 30, 2015 were divided into FOLFOX group (CapeOx group) and FOLFIRI group (FOLFOX group). Taking total hospitalization cost as the cost and PFS as the effect, the cost-effect analysis and sensitivity analysis of three chemotherapy regimens were carried out, and the effects of domestic chemotherapeutic drugs and medical insurance payment on the results were evaluated. Results: there was no statistical difference between the two groups (P 0.05). The PFS of CapeOx group (392 cases) and FOLFIRI group (150 cases) were comparable (P0.05). The PFS of CapeOx group and FOLFIRI group were 154.15 days 156.16 days and 165.84 days, respectively. The total cost of treatment was 63 956.11 yuan 73 826.06 yuan and 79 259.20 yuan respectively. The cost-effectiveness ratio was 414.90472.76 and 477.93 respectively. On the basis of FOLFOX scheme, the additional cost of PFSU FOLFIRI scheme and CapeOx scheme is 57.86 yuan and 59.69 yuan respectively. Sensitivity analysis results are consistent with cost-effect analysis. Subgroup analysis showed that the effect of domestic drugs was slightly lower than that of imported drugs, and the cost was higher than that of imported drugs, and the cost-effect ratio was lower than that of imported drugs. Pharmacoeconomics is better than FOLFOX, CapeOx, FOLFIRI, and Medicare, which is more effective than FOLFOXFOLFIRICapeOx. Conclusion the lowest cost is FOLFOX, the best is FOLFIRI, and the best in economics is FOLFOX.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院藥學(xué)部;
【基金】：江蘇省藥學(xué)會(huì)奧賽康臨床藥學(xué)基金(編號(hào):201308)
【分類號(hào)】：R956

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