摘要
目的通过分析非小细胞肺癌靶向治疗直接医疗成本及其影响因素,从医疗角度比较非小细胞肺癌靶向治疗的经济性,以期为临床选用安全、有效、经济的靶向治疗方案提供参考。方法采用回顾性调查方法,收集2011年1月至2015年12月期间某三级甲等医院非小细胞肺癌靶向治疗患者的临床资料,运用最小成本分析法比较不同靶向药物治疗患者住院期间直接医疗成本的差异。结果非小细胞肺癌患者住院总费用包括药品费用、化验费用、检查费用、床位费用、材料费用、护理费用、诊疗费用、手术费用、麻醉费用和其他杂费,占比最高的是药品费用,其次为化验费用。采用吉非替尼和厄洛替尼治疗的进口组与埃克替尼治疗的国产组在住院总费用、药品费用、靶向药品费用、床位费用之间差异具有统计学意义;进口组与国产组在化验费用、治疗费用、护理费用、检查费用、耗材费用之间差异不具有统计学意义。在转归结果一致的情况下,得出进口组直接医疗成本均值为123 926元,埃克替尼治疗的国产组直接医疗成本均值为73 805元,即住院治疗成本最小者为埃克替尼治疗组。结论确诊为非小细胞肺癌后经基因检测明确是EGFR突变的前提下,选择埃克替尼进行靶向治疗是一种有效、合理、经济的治疗方案。
AIM To analyse the cost of medical treatment and the influencing factors of non-small cell lung cancer （NSCLC） targeted therapy, and evaluate the economic impact of NSCLC targeted therapy by using cost-min- imization analysis to provide a safe, effective and economical targeted therapy for clinical using. METHODS A retrospective study was performed on the clinical data of patients with NSCLC targeted therapy in a third-grade elass-A hospital from January 2011 to December 2015. The cost-minimization analysis was used to analyse the direct medical cost during hospitalization of gefitinib group, erlotinib group and icotinib group. RESULTS The total hospitalization cost of patients with NSCLC included fees for drugs, laboratory tests, examination, sickbeds, materials, nursing, treatment, surgery, anesthesia and the others. In these costs, the highest proportion was drug costs, and followed by the inspection fees. The import group and the domestic group had significant difference between the cost of hospitalization, drugs, targeted drugs and sickbeds. The import group （treated with gefitinib and erlotinib） and the domestic group （treaded with icotinib） had no significant difference between the cost of laboratory tests, treatment, nursing, examination and materials. In the case of consistent outcome, the results showed that the average cost of direct medical treatment in import group was 123 926 yuan, and the average cost of medical treatment in domestic group was 73 805 yuan. Cost-minimization analysis showed that lowest hospitalization cost was the icotinib group. CONCLUSION It could be seen that targeted treatment of icotinib is effective, reasonable and economical under the premise of clear detection of epidermal growthfactor receptor mutation after the diagnosis of NSCLC.
作者
赵云
张美玲
ZHAO Yun;ZHANG Meiling(Department of Pharmacy, Taizhou Hospital of Zhejiang, Linhai 317000 , China;Department of Pharmacy, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China)
出处
《中国临床药学杂志》
CAS
2018年第3期167-171,共5页
Chinese Journal of Clinical Pharmacy
