托烷司琼与帕洛诺司琼预防化疗胃肠道反应的成本-效果分析

he Cost-Effectiveness Analysis of Tropisetron and Palonosetron in Preventing Gastrointestinal Side Effects after Chemotherapy

目的:比较托烷司琼与帕洛诺司琼预防化疗胃肠道反应的疗效及成本-效果。方法:选取60例采用吉西他滨+顺铂方案化疗的局部晚期非小细胞肺癌患者,将其按随机数字表法分为两组(帕洛诺司琼组和托烷司琼组),分别给予托烷司琼和帕洛诺司琼止吐处理,观察相关疗效及运用药物经济学成本-效果分析法进行评价。结果:帕洛诺司琼与托烷司琼在治疗急性呕吐控制方面,其有效率比较差异无统计学意义(P<0.05);但在恶心程度的控制上,帕洛诺司琼的有效率为73.3%,每周期化疗人均止吐药物成本为(718.00±0.49)元,有效率每增加1个百分点,成本为(9.79±0.08)元;托烷司琼的有效率为43.3%,每周期化疗人均止吐药物成本为(692.48±0.52)元,有效率每增加1个百分点,成本为(15.99±0.11)元。以低成本(托烷司琼)为参照,帕洛诺司琼组与之对比增加的成本-效果比为(0.85±0.61)元。两组患者均未发现不良反应。结论:帕洛诺司琼治疗化疗胃肠道反应疗效优于托烷司琼,成本-效果比亦优于托烷司琼。

Objective：To compare efficacy and cost-effectiveness of tropisetron and palonosetron preventing gastrointestinal side effects of chemotherapy. Method：60 patients treated with gemcitabine and cisplatin chemotherapy for locally advanced non-small cell lung cancer were randomly divided into two groups according to random number table method,were treated with tropisetron and palonosetron. The efficacy and costs-effectiveness analysis with pharmacoeconomics were evaluated. Result：There was no significant difference in controlling acute vomiting between the two groups（P〉0.05）. Efficiency rate of palonosetron in the control of nausea was 73.3%,antiemetic drug costs each cycle of chemotherapy was（718 ± 0.49）yuan,efficiency of each increase of 1 percentage points,the cost was（9.79 ± 0.08）yuan;Efficiency rate of tropisetron in the control of nausea was 73.3%,antiemetic drug costs each cycle of chemotherapy was（718 ± 0.49）yuan,efficiency of each increase of 1 percentage points,the cost was（9.79 ± 0.08）yuan. At low cost（tropisetron）as the reference,the increase cost of the palonosetron group was（0.85 ± 0.61）yuan. Adverse reactions were not found in the two groups. Conclusion：Palonosetron is more effective than tropisetron in preventing gastrointestinal reactions of chemotherapy and the cost-effectiveness ratio is also superior to tropisetron.