参芪扶正注射液联合化疗用于非小细胞肺癌的药物经济学评价

Pharmacoeconomics Evaluation of Shenqi Fuzheng Injection Combined with Chemotherapy for Non-small Cell Lung Cancer

目的:评价参芪扶正注射液联合化疗与单独化疗用于非小细胞肺癌的经济学价值,为药品支付及临床治疗提供参考依据。方法:采用前瞻性设计,根据参芪扶正注射液销售地区和医院分布情况选择国内11家医院516例非小细胞肺癌患者作为研究对象,基于临床实际治疗方案自然形成参芪扶正注射液联合化疗组267例和单独化疗组249例。以生活质量量表(FACT-L)评分、功能状态量表(KPS)评分、体力状况(ZPS)评分为效果指标,质量调整生命年(QALYs)为效用指标,观察时限为21 d,进行成本-效果和成本-效用分析。结果:FACT-L 5个维度评分结果表明,参芪扶正注射液联合化疗组患者均能得到有效改善,且成本-效果比低于单独化疗组的患者。KPS评分结果表明,参芪扶正注射液联合化疗组患者的成本-效果比低于单独化疗组(1 632.44 vs.11 145.30),且增量成本-效果比仅为448.69。ZPS评分结果表明,参芪扶正注射液联合化疗组患者的成本-效果比低于单独化疗组(-17 398.77 vs.384 513.00)。参芪扶正注射液联合化疗组患者平均每获得1个QALYs需付出的成本低于单独化疗组(1 313 326元vs.13 374 365元)。结论:与单独化疗比较,参芪扶正注射液联合化疗能有效提高患者生存质量,且使用参芪扶正注射液多付出的治疗成本从药物经济学角度上来看是值得的。

OBJECTIVE：To evaluate the economic value of Shenqi fuzheng injection combined with chemotherapy vs. chemotherapy alone for non-small lung cancer（NSCLC）,and to provide reference for drug payment and clinical treatment. METHODS：By prospective cohort design,516 patients with non-small cell lung cancer from 11 hospitals were selected as subjects according to the sale distribution of Shenqi fuzheng injection in district and hospital;267 cases of Shenqi fuzheng injection combined with chemotherapy and 249 cases of chemotherapy alone formed naturally according the clinical therapy plan. The cost-effectiveness and cost-utility analysis were conducted using FACT-L score,KPS score and ZPS score as effect index,QALYs as effectiveness index observation period of 21 d. RESULTS：5 dimensions FACT-L score：the patients of Shenqi fuzheng injection combined with chemotherapy group could be effectively improved,and the cost-effectiveness ratio was lower than chemotherapy alone group;KPS score：the cost-effectiveness ratio of Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group（1 632.44 vs. 11 145.30）,and incremental cost-effectiveness ratio was 448.69. ZPS score：Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone（-17 398.77 vs. 384 513.00）. Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group in average cost per 1 QALYs（1 313 326 yuan vs.13 374 365 yuan）. CONCLUSIONS：Compared with chemotherapy alone group,Shenqi fuzheng injection combined with chemotherapy can effectively improve the quality of life,and it is worth of spending more money on Shenqi fuzheng injection from the perspective of the pharmacoeconomics.