【作者】 吴晶； 张楠； 董鹏；

【Author】 Jing Wu 1,Nan Zhang 1,Peng Dong 2 1 School of Pharmaceutical Science and Technology,Tianjin University,Tianjin,China,300072;2 Pfizer China,Beijing,100020

【机构】 天津大学药物科学与技术学院； 辉瑞制药有限公司；

【摘要】 目的比较和评价三种药物舒尼替尼、索拉非尼、IFN-α在卫生资源使用、治疗费用及健康产出等方面的差异,从而识别哪种药物具有更好的成本-效果,为政府报销决策和临床用药提供决策依据。方法使用基于Microsoft Excel建立的马尔科夫模型来模拟5年的疾病进展、成本及健康产出。运用成本-效果分析(Cost-effectiveness Analysis,CEA)对转移性肾细胞癌mRCC一线治疗药物舒尼替尼、索拉非尼、IFN-α进行经济学分析。采用增量成本-效果比评价最终结果。结果模拟5年的成本结果显示舒尼替尼的人均成本高于IFN-α组,低于索拉非尼组;5年的健康结果显示舒尼替尼组患者获得的生命年及质量调整生命年均大于索拉非尼组和IFN-α组。结论舒尼替尼与IFN-α相比不具有成本效果优势,与索拉非尼相比则为成本节约方案。更多还原

【Abstract】 OBJECTIVE:To assess the cost-effectiveness of Sunitinib malate as a first-line treatment in metastatic renal cell carcinoma (mRCC) compared with Sorafenib and interferon-alfa (IFN-α) in the Chinese healthcare setting.METHODS:A Markov model was developed in Microsoft Excel to simulate disease progression and determine outcomes over 5 years of a hypothetical cohort with mRCC receiving first-line treatment (in 6-week cycles,4 weeks treatment plus 2 weeks off treatment) with Sunitinib compared with Sorafenib as well as IFN-α.RESULTS:The reference case results indicated that in terms of total average cost per patient over 5 years,sunitinb was less costly than Sorafenib,and more costly than IFN-α.Concerning health outcomes,the estimated gains for one patient treated with sunitnib over IFN-α were 0.25 LYs and 0.24 QALYs,and over Sorafenib were 0.09 LYs and 0.12 QALYs.Moreover,Sorafenib was dominated by Sunitinib with positive incremental QALYs and negative incremental costs.CONSLUSION:Results suggest that Sunitinib has better clinical efficacy compared to Sorafenib and IFN-α,and is a cost-saving alternative to Sorafenib as a first-line treatment for mRCC in China.Given the cost-effectiveness threshold $ 66,000 in China,Sunitinib was not as cost-effective as IFN-α.更多还原