吉非替尼治疗晚期非小细胞肺癌的药物经济学评价

Pharmacoeconomic evaluation of gefitinib in the treatment of advanced non-small cell lung cancer

目的:评价吉非替尼作为二线药物治疗晚期非小细胞肺癌(NSCLC)的经济性。方法:以多西他赛为对照,构建决策分析模型。效果和不良反应数据来源于文献资料的Meta分析结果,成本项目使用数量和单价来源于文献资料、专家意见和网上药店数据。结果:在基础分析中,吉非替尼组1年内平均成本低于多西他赛组(23 022元vs 24 390元);吉非替尼组的有效率显著高于多西他赛组(26.90%vs 10.30%),而在临床控制率和1年生存率指标方面,吉非替尼组与多西他赛组无显著差异。因此,吉非替尼组具有优势。在敏感性分析中,结果与基础分析相似。结论:吉非替尼作为二线药物治疗晚期NSCLC效果略优于多西他赛,安全性明显更优;吉非替尼经济性优于多西他赛。

Objective： To evaluate the cost-effectiveness of gefitinib in the treatment of advanced non-small cell lung cancer （NSCLC）. Methods： A decision tree model was constructed with docetaxel as the eomparator. The efficacy and safety of gefitinib and doeetaxel were derived from the Meta analysis of published studies. The consumption and unit cost of variety of health resources were obtained from published studies, expert opinion and on- line drug stores. Results： In base case analysis, the average cost within one year was lower in gefitinib group than in docetaxel group （23 022 RMB vs 24 390 RMB）. ORR was significantly higher in gefitinib group than in docetaxel group （26.90% vs 10.30% ）. DCR and one year survival rate was not significantly different between the two groups. As a result, gefitinib group was dominant. In the sensitivity analysis, the results were similar with base case analysis. Conclusion： Gefitinib is slightly more effective and significantly safer than docetaxel as a second line treatment for advanced NSCLC. Gefitinib is more cost-effective in comparison with expensive brand of docetaxel, but probably not cost-effective when compared with low price domestic generic docetaxel.