3种不同止吐方案防治顺铂所致呕吐的成本-效果分析

The Cost-Effectiveness Analysis of Three Preventing Schemes for Cisplatin-Induced Vomiting

目的比较3种5-羟色胺3受体拮抗剂治疗顺铂所致呕吐的经济学效果。方法 3组患者顺铂化疗期间分别予以帕洛诺司琼(A组)、阿扎司琼(B组)及格拉司琼(C组),观察对于呕吐反应防治的有效率,并采用药物经济学方法进行成本-效果分析。结果 A、B、C组对于急性呕吐的有效率分别为85.0%、80.4%、78.6%,比较差异无统计学意义(P>0.05);成本分别为925.2元、349.5元及276.7元,其中C组所需成本最低(P均<0.05)。但对于延迟性呕吐的有效率,A组明显高于其他2组(P均<0.05),成本-效果分析也以A组最佳。结论对于顺铂所致急性呕吐,格拉司琼是较为合理方案;而对于延迟性呕吐,帕洛诺司琼更优。

Objective To evaluate the cost-effectiveness of three 5-hydroxy tryptamine 3 （5-HT3 ） receptors suppressant for cisplatin-induced vomiting. Methods All the patients received cisplatin chemotherapy were randomly divided into three groups according to the preventing schemes： group A （treated with palonosetron） ,group B （treated with azasetron） and group C （treated with granisetron）. The data were analyzed by using pharmacoeconomic cost-effectiveness analysis. Results The response rate of prevention of acute vomit were 85.0% ,80.4% ,78.6% in group A, B, C （ P 〉 0.05 ） ; the costs in group A, B, C were 925.2,349.5 and 276.7 yuan （ P 〈 0.05 ） ,the costs in group C was the lowest. While palonosetron （ group A） was superior to azasetron （ group B ） and granisetron （ group C） in the prevention of chronic vomit （ P 〈 0.05 ）, the result of cost-effectiveness analysis showed that group A was the best. Conclusion For the prevention of acute vomit induced by cisplatin, granisetron is the most economical one; while for the chronic vomit,palonosetron is the most.