【作者】 罗霞； 彭六保； 万小敏； 谭重庆； 崔巍； 曹俊华；

【Author】 LUO Xia,PENG Liu-bao,WAN Xiao-min,TAN Chong-qing,CUI Wei,CAO Jun-hua (Department of Pharmacy,the Second Xiangya Hospital of Central South University,Changsha HU-NAN 410011,China)

【机构】 中南大学湘雅二医院药剂科；

【摘要】 目的对乳腺癌辅助化疗方案TAC与FAC开展药物经济学研究,以期为临床决策提供参考依据。方法建立Markov模型对接受TAC与FAC辅助化疗的病人进行模拟,综合运用临床试验BCIRG001研究结果、其他公开发表的文献和某大型综合性医院的病历资料。结果五年TAC组的效果值为4.043QALYs,比FAC多0.078QALYs;成本为104597.23元,比FAC多4305.50元,增量成本-效果比为55016元/QALY。一元敏感度及概率敏感度分析表明Markov模型对重要参数都较稳定。结论从中国医疗卫生体系角度,五年内辅助化疗方案TAC比FAC对淋巴结阳性早期乳腺癌患者更具有成本效果性。更多还原

【Abstract】 OBJECTIVE The cost-effectiveness analysis of docetaxel /doxorubicin /cyclophosphamide (TAC) and cycles of fluorouracil /doxorubicin/cyclophosphamide (FAC) was performed in this study using Markov model, which could be the basis for decision- making by clinical workers. METHODS A Markov model was built to simulate the process of breast cancer events and death occurred in both TAC and FAC arms patients. Data were collected from the clinical trial BCIRG 001, some publicized literatures and patients’ diaries of a large Chinese comprehensive hospital. RESULTS The 5 years results showed that patients receiving TAC gained 4.043 QALYs which were 0.078 QALYs more than patients receiving FAC. The ICER value was 55016yuan/QALY. The costs of patients receiving TAC were 104597.23yuan which were 4305.50 Yuan more than that of FAC. The results were robust to key parameters in both one-way sensitivity analysis and probabilistic sensitivity analysis. CONCLUSION In conclusion, from a Chinese health system perspective, TAC is more effective and costly compared with FAC regimen for node-positive early breast cancer patients in 5 years horizon.更多还原