G-CSF治疗化疗引起白细胞减少症三种方法的成本/效果分析

A Comprison of Cost-effectiveness Among Three Ways of rhG-CSF in Treatment Leukopenia After Chemotherapy

目的 :确定标准剂量化疗后重组人粒细胞集落刺激因子 (rhG CSF)合理的用药方法。方法 :采用前瞻性自身对照方法 ,分别以不同顺序进行 3个疗程化疗加rhG CSF治疗 ,A周期为化疗后预防性应用rhG CSF ,B周期为化疗后出现Ⅳ度白细胞下降 ,再予rhG CSF治疗 ,C周期为出现Ⅱ度白细胞下降后加用rhG CSF治疗 ,用药物经济学成本 /效果分析方法 ,对其疗效及成本进行评价。结果 :化疗后预防性应用rhG CSF和Ⅱ度白细胞下降后予rhG CSF ,与Ⅳ度白细胞下降后应用rhG CSF相比 ,疗效均明显提高 ,分别为 76 %、80 %、4 6 % ,前二者之间疗效差异无显著性 ,前者疗效每提高 1% ,成本增加 55 14元 ,后者疗效每提高 1% ,成本增加 1391元。结论 :标准剂量化疗 ,出现Ⅱ度白细胞下降后应用rhG CSF ,最有效、经济。

Objective To determine the rational way of rhG CSF usage after standard dose chemo therapy.Methods With randomized prospective self contrast method,three cycles of chemotherapy with rhG CSF were taken in different ways.The ways were as following:①Cycle A:rhG CSF was taken as preventive way after chemotherapy.②Cycle B:rhG CSF was taken to treat Ⅳleucopenia after chemotherapy.③Cycle C:RhG CSF was taken to treatⅡleucopenia after chemotherapy.The effect and the cost of every way of rhG CSF usage were then evaluated with pharmacoeconomic cost effectiveness analysis.Results The effectiveness of cycle A and cycle C is higher than that of cycle B.The effective rates are 76%,80%,46%,respectively.There is no statistical significance between cycle A and cycle C.When 1% of effective rate increased,5514 yuans were cost accordingly in cycle A,as to the way in cycle C,1391 yuans.Conclusions The treatment of rhG CSF should be taken when stage Ⅱ leucopenia happens after standard dose chemotherapy.It is the most effective?economical and rational way.