摘要
目的基于卫生服务体系角度评估贝伐珠单抗联合紫杉醇在HER-2阴性转移性乳腺癌(metastatic breast cancer,MBC)中的成本效果。方法根据E2100试验的疗效和不良事件中的数据,采用动态Markov模型模拟患者终身的直接医疗成本和质量调整生命年(quality-adjusted life years,QALYs)。以增量成本-效果比(incremental cost-effectiveness ratio,ICER)为评价指标,评价贝伐珠单抗联合紫杉醇与紫杉醇治疗MBC方案的优劣,并分析结果敏感度。健康效用来自现有文献,费用从河北医科大学第四医院获取。结果贝伐珠单抗联合紫杉醇对比紫杉醇提高了0.28 QALYs,成本增加了182806元,ICER为652879元/QALY,每增加1年无进展生存期的成本为355471元。结论贝伐珠单抗联合紫杉醇能延长HER-2阴性MBC患者的生命年,提高生命质量,同时也增加医疗成本,根据WHO 3倍人均GDP的判断标准,贝伐珠单抗联合紫杉醇用于HER-2阴性MBC的一线治疗不具有成本效果优势。
OBJECTIVE To assess the cost-effectiveness of bevacizumab in combination with paclitaxel in HER-2 negative metastatic breast cancer(MBC)from a health service system perspective.METHODS Based on data from the efficacy and adverse events of the E2100 trial,a dynamic Markov model was used to simulate direct medical costs and quality-adjusted life years(QALYs)over the lifetime of patients.Incremental cost-effectiveness ratio(ICER)was used as an evaluation index to evaluate the advantages and disadvantages of bevacizumab combined with paclitaxel versus paclitaxel in the treatment of metastatic breast cancer,and the sensitivity of the results was analyzed.Health utilities were obtained from existing literature and costs were obtained from The Fourth Hospital of Hebei Medical University.RESULTS Bevacizumab combined with paclitaxel increased 0.28 QALYs compared with paclitaxel,and the cost increased 182806 yuan,then ICER was 652879 yuan/QALY,and the cost per additional one-year progression-free survival was 355471 yuan.CONCLUSION Bevacizumab combined with paclitaxel can prolong the life years of HER-2 negative MBC patients,improve the quality of life,but also increase medical costs.According to the 3 times of GDP per capita judgment criteria of WHO,bevacizumab combined with paclitaxel for first-line treatment of HER-2 negative MBC has no cost-effectiveness advantage.
作者
梁平
王玉栋
白靖
邓淇均
魏宗敏
徐彤
候娟
刘江
LIANG Ping;WANG Yudong;BAI Jing;DENG Qijun;WEI Zongmin;XU Tong;HOU Juan;LIU Jiang(Department of Pharmacy,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Medical Oncology,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)
出处
《中国现代应用药学》
CAS
CSCD
北大核心
2021年第1期82-86,共5页
Chinese Journal of Modern Applied Pharmacy
基金
河北省医学科学研究重点课题计划(20170739)。
