三种化疗方案治疗进展期胃癌的成本效果分析

Cost-effectiveness analysis of three chemotherapeutic schemes for advanced gastric cancer

目的:总结探讨不同化疗方案治疗进展期胃癌的成本效果比。方法:收集上海长海医院普外科2003年6月至2004年6月间收治的96例进展期胃癌患者的治疗数据。根据用药方案的不同,分成3组:A组32例(多西他赛+顺铂+5-氟尿嘧啶+亚叶酸钙);B组30例(盐酸表柔比星+顺铂+5-氟尿嘧啶+亚叶酸钙);C组34例(奥沙利铂+5-氟尿嘧啶+亚叶酸钙),运用成本效果分析方法对三种化疗方案进行经济学评价。结果:在三种化疗药物治疗方案中,多西他赛组有效率为56．25%,1个疗程的治疗成本为9979元,成本效果比177．40(元/百分之一有效率);盐酸表柔比星组有效率为40．00%,1个疗程的治疗成本为4158元,成本效果比103．95(元/百分之一有效率);奥沙利铂组有效率为52．94%,1个疗程的治疗成本为4498元,成本效果比84．96(元/百分之一有效率)。增量成本效果分析表明,A组的(⊿C/⊿E)为358．22;C组的(⊿C/⊿E)为26．28。结论:C方案是三种化疗方案治疗进展期胃癌的最合理方案。

Objective：To explore the cost-effectiveness of different chemothrapeutic schemes in the treatment of advanced gastric cancer, Methods ：96 cases of gastric cancer were divided into three groups receiving different medication. A group（ 32 cases）with Do- eetaxel ＋ Fluorouraeil（5 - FU） ＋ Calcium folinate（CF） ＋ Cisplatin（DDP） ;B group （30 cases）with Epirubiein ＋ DDP ＋ 5 - FU ＋ CF; C group （ 34 cases） with Oxaliplatin ＋ 5 - FU ＋ CF. Date was evaluated using clinic economics cost-effectiveness analysis. Results： Among three groups ,the effective rate of A group was 56. 25% and expenditure of one therapeutic course was 9 979 yuans, 1% increase of effective rate 177.40 yuans. The effective rate of A group was 40. 00% and expenditure of one therapeutic course was 4 158 yuans, increase of 1% effective rate was costed 103.95yuans. The effective rate of C group was 52. 94% and expenditure of one therapeutic course was 4 498 yuans, 1% increase of effective rate costed 84. 96 yuans. Conclusions ： C schemes is the most rational one among three chemotherapeutic programs for advanced gastric cancer.