舒尼替尼治疗转移性肾细胞癌患者的药物经济学评价

Pharmacoeconomic Evaluation of Sunitinib for the Treatment of Metastatic Renal Cell Carcinoma

目的：评价舒尼替尼、索拉非尼、干扰素α（IFN-α）在卫生资源使用、治疗费用及健康产出等方面的差异，从而分析哪种药物具有更好的成本．效果，为政府报销和临床用药提供决策依据。方法：使用基于Microsoft^RExcel建立的Markov模型来模拟5年的疾病进展、成本及健康产出，运用成本一效果分析对转移性肾细胞癌一线治疗药物舒尼替尼、索拉非尼、IFN-α进行经济学评价。结果：模拟5年的成本结果显示，舒尼替尼组的人均成本高于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-αc相比不具有成本·效果优势，但与索拉非尼相比则为成本节约方案。

OBJECTIVE： To evaluate the difference of sunitinib, sorafenib and interferon-u （IFN-α） in terms of health source utilization, treatment cost and health output, and to analyze the optimal cost-effectiveness and provide reference for reimbursement decision and clinical drug use decision. METHODS： A Markov model was developed by using Microsoft^R Excel to simulate disease progression, cost and health outcomes over 5 years. Cost-effectiveness analysis was adopted for economic analysis of sunitinib, sorafenib and IFN-α for the first-line treatment of metastatic renal cell carcinoma. RESULTS： The reference case results indicated that, total average cost per capita of sunitinb group was higher than IFN-α group but lower than sorafenib group over 5 years; concerning health outcomes, obtained life year and quality adjusted life year of sunitinb group both were higher than those of sorafenib group and IFN-α group. CONCLUSION： Results suggest that sunitinib is not as cost-effective as IFN-α, but it is a cost-saving alternative to sorafenib.