中药注射剂辅助NP方案治疗老年非小细胞肺癌的循证药物经济学评价

Pharmacoeconomics Analysis of Chinese Herb Injection Combined with NP Chemotherapy in Treatment of Non-small Cell Lung Cancer

目的:评价3种中药注射剂辅助NP方案(长春瑞滨联合顺铂)治疗老年非小细胞肺癌的有效性和经济性。方法:计算机检索CNKI,CBM和Wan Fang Data,查找有关中药注射剂辅助NP方案治疗老年非小细胞肺癌的文献。由2位评价员根据纳入标准独立进行文献筛选、资料提取和质量评价后,采用网络Meta分析和药物经济学评价方法进行分析。结果:纳入14个研究,共1 118例患者。网络Meta分析结果显示:在近期疗效方面,康莱特联合NP疗效最优,排名第一的概率为71%;在生活质量方面,参芪扶正联合NP效果最好,排名第一的概率为56%。经济学评价表明,4种治疗方案的成本效果比/增量成本效果比分别为:艾迪联合NP为425.88元/425.88元,康莱特联合NP为385.23元/213.05元,参芪扶正联合NP为389.77元/118.97元,NP方案为477.18元/0元。结论:参芪扶正联合NP方案具有相对经济性,为优选方案。但需今后进一步大样本、严格的随机对照研究加以验证。

Objective： The aim of this study was to perform economic evaluation and network Meta- analysis of three Chinese herb injections combined with NP chemotherapy for non-small cell lung cancer （ NSCLC）. Method： CNKI, CBM and Wanfang Databases were searched to include clinical trials about Chinese herb injections combined with NP chemotherapy for elderly NSCLC. Two evaluators independently selected the trials, performed the data extraction and evaluated the quality of included studies. Network Meta-analysis and pharmacoeconomies analysis were conducted. Result： A total of 14 randomized clinical trials （RCTs） involving 1 118 patients were included. Kanglaite injection ＋ NP chemotherapy ranked first and had the highest probability in the outcome of near-term curative effect （71% ）. Shenqi Fuzheng injection ＋ NP chemotherapy ranked first and had the highest probability in the outcome of quality of life （56%）. The economic evaluation showed that, the cost- effectiveness ratios and incremental cost-effectiveness ratio of four therapy strategies were as follows： Aidi injection ＋ NP 425.88/425.88 yuan, Kanglaite injection ＋ NP 385.23/213.05 yuan, Shenqi Fuzheng injection ＋ NP 389.77/118.97 yuan, and NP chemotherapy 477.18/0 yuan, respectively. Conclusion： Shenqi Fuzheng injection ＋ NP chemotherapy is considered as an optimum treatment. But we need more strictly-designed and RCTs of large-scale sample to support our conclusion.