9.西妥昔单抗治疗转移性大肠癌的经济学评价教案分析.docx

西妥昔单抗治疗转移性大肠癌的经济学评价国家科技支撑计划子课题（No.2013BAI06B04） 作者简介：田泾：硕士研究生在读，消化科临床药师，主要从事临床药学与带教工作 *通讯作者：高 申：博士生导师，主任药师，主要从药剂学与医院药学，ggss99@126.com 田泾，严萍萍，王卓，高申* （上海长海医院，上海 200433） [摘 要] 目的：对西妥昔单抗治疗转移性大肠癌(mCRC)做经济学评价。方法：基于社会视角，采用二次文献研究和模型研究方法，根据接受化疗的转移性大肠癌患者健康状态发展规律，构建Markov模型，对比西妥昔单抗联合氟尿嘧啶为基础的方案（C+FBC）与单独使用氟尿嘧啶为基础的方案（FBC），以成本效果比（CER）、增量成本效果比（ICER）作为评价指标，并对结果进行敏感度分析。结果：以14天为一个模型周期，在120个模型周期内，C+FBC组转移性大肠癌患者获得的质量调整生命年(QALY)为1.821年，FBC组转移性大肠癌患者获得的质量调整生命年(QALY)为0.942年，C+FBC组费用为3430757.5元，FBC组费用为617064.5元。C+FBC组成本效果比为1883996.4，FBC组成本效果比为655057.9，增量成本效果比为3201012.5。进行敏感性分析对结果没有影响。结论：单独使用氟尿嘧啶为基础的方案对于转移性大肠癌患者更具有成本效果。 [关键词] 马尔可夫模型；西妥昔单抗；转移性大肠癌；经济学评价 Economic analysis of cetuximab in therapy of metastatic colorectal cancer Jing TIAN,Pingping YAN,Zhuo WANG,Shen GAO* （Department of Pharmacy,Changhai Hospital, Second Military Medical University,Shanghai 200433,China） [Abstract] Objective: To evaluate the cost-effectiveness of cetuximab in therapy of metastatic colorectal cancer. Methods: The evaluation is based on social perspective．A markov model is constructed to simulate the development of the health status of patients receiving chemotherapy for metastatic colorectal cancer, comparing of fluoropyrimidine-based chemotherapy in combination with cetuximab（C+FBC） and fluoropyrimidine-based chemotherapy (FBC).Cost-effectiveness ratio（CER） and incremental cost-effectiveness ratio（ICER）are used as the evaluation indicators in the study．Sensitivity analysis is done to make sure that the conclusion is reliable．Results: Within 120 cycles （14 days as one cycle） of the model，the quality-adjusted life year (QALY) of the C+FBC group patient are 1.821 years,and the FBC group patient are 0.942 years．It costs 3430757.5 yuan for the patients of C+FBC group，while the cost for patients of FBC group are 617064.5 yuan．the CER of C+FBC group is 1883996.4, while the CER of FBC group is 655057.9. The ICER is 3201012.5. Sensitivity analysis results show that did not change the base case conclusions.Conclusion: Th