肠癌一线治疗_培训课件.ppt

* * * * * * * * * * * The retrospective, claims-based analysis evaluated the cost of first- or second-line XELOX vs. FOLFOX using Thomson Reuters Marketscan databases. Mean monthly total medical expenditure cost was US$11,473 for patients receiving XELOX vs. US$14,300 for those receiving FOLFOX. Mean monthly acquisition costs were similar for XELOX (US$6,145) and FOLFOX (US$6.008), but chemotherapy administration costs were lower for XELOX (US$404 vs. US$1,437). The costs of chemotherapy-related complications were also lower for XELOX (US$1,578 vs. US$2,516). In the metaststic setting, treatment with XELOX is associated with a lower monthly medical cost that FOlFOX (-US$2,827). Cartwright et al. ASCO GI 2009 * A cost-minimisation analysis was performed using data from a phase III study (ML16987) comparing XELOX with FOLFOX-6 as first-line therapy in MCRC. The average cost per patient was significantly lower with XELOX (€12,918) than with FOLFOX-6 (€17,226). Hospitalisations for chemotherapy represented 30% of the total cost for XELOX compared with 55% for FOLFOX-6. XELOX significantly decreased direct treatment costs of MCRC patients, as well as their mean length of hospital stay. Perrocheau et al. ASCO GI 2009 * * * FOLFOX4 XELOX XELOX方案减少输液时间 FOLFOX6 每6周治疗的预期输液时间 4h 147h 147h Cassidy et al. J Clin Oncol In pressDucreux et al. ASCO 2007 交叉对照试验 XELOX + Avastin FOLFOX4 + Avastin 中位就诊次数 XELOX FOLFOX4 Scheithauer et al. ASCO 2007 FOLFOX方案患者更多接受中心静脉置管 XELOX减少诊疗时间 XELOX ：理想的转移性结直肠癌治疗方案 有效 在一线治疗中，贝伐单抗 + XELOX 疗效等同于贝伐单抗 + FOLFOX 在一、二线治疗中，XELOX 疗效等同于 FOLFOX 耐受良好 更少的中性粒细胞减少症、中性粒细胞减少性发热和静脉血栓栓塞（VTEs）发生 副反应可控制 应用灵活性 简化与生物制剂的联合应用 更少的诊疗时间 应用灵活，适合剂量调整 医疗成本如何? 希罗达与静脉5FU总医疗费用比较 卡培他滨替代静脉5-FU的化疗，减少总医疗费用 XELOX方案和FOLFOX方案治疗胃癌的总医疗费用比较 药品费用虽然高于5-FU方案，但在给药成本和不良反应处理费用方面要远低于5-FU方案； 不计陪护、交通等费用，从总医疗费用的角度来看，卡培他滨方案治疗实体肿瘤比5-FU方案的成本更低。 卡培他滨方案 FOLFOX方案 差异 中位疗程数(最小值，最大值) 6（4, 8） 9（4, 12） - 药品费用* 33,948 19,788 14,160 化疗药物给药费用 596 10,581 -9,985 不良反应处理费用 1,650 3,477 -1,828 住院相关费用