目的 對卡培他濱治療晚期轉(zhuǎn)移性結(jié)直腸癌進行經(jīng)濟學評價。方法 基于卡培他濱和5-氟尿嘧啶+亞葉酸鈣(5-FU+LV)治療晚期轉(zhuǎn)移性結(jié)直腸癌的Meta分析結(jié)果,將各個方案的結(jié)局終點分別設(shè)為緩解、穩(wěn)定、無效,通過臨床調(diào)查天津市三級醫(yī)院相關(guān)的醫(yī)療服務價格,利用Treeage軟件進行決策樹的模型建立,最后進行成本-效果分析以及敏感性分析。結(jié)果 卡培他濱組的療效略好于5-FU+LV組,其治療成本高于5-FU+LV組。通過單因素敏感性分析發(fā)現(xiàn),結(jié)局指標穩(wěn)定,結(jié)局未發(fā)生逆轉(zhuǎn)。結(jié)論 與5-FU+LV方案相比,卡培他濱口服使用方便且臨床療效肯定,盡管直接醫(yī)療成本-效果分析發(fā)現(xiàn),其無顯著經(jīng)濟學優(yōu)勢,但其間接成本和隱性成本費用低,具有一定的臨床推廣應用價值。

Objective To evaluate the economic significance of capecitabine in treatment of advanced or metastatic colorectal cancer. Methods Based on Meta-analysis of the clinical efficacy of capecitabine and 5-fluorouracil/leucovorin (5-FU/LV) in treatment of advanced or metastatic colorectal cancer, the outcomes of the end points were set as objective release, stable disease, and progressive disease. The price of medical services in tertiary hospitals in Tianjin was investigated, and the cost-effectiveness analysis was conducted with Treeage decision tree and further sensitivity analysis was carried out. Results The efficacy of capecitabine group was better than that of 5-FU/LV group, however the treatment cost was higher than that of 5-FU/LV group. The single factor sensitivity analysis showed that the outcome indicators were stability and the end was not reversed. Conclusion Compared with the 5-FU/LV regime, capecitabine is easy to taken orally, and the clinical efficacy is sure. Although direct medical cost-effectiveness analysis shows capecitabine has no significant economic advantage, however the indirect costs and intangible costs of capecitabine is lower, which has a certain clinical application value.

"十二五"國家科技支撐計劃課題(2013BAI06B04)