《NCCN止吐临床实践指南(v1.2014)》依从性及5-HT_3受体拮抗剂预防呕吐经济学评价

Evaluation of Compliance to NCCN Clinical Practice Guidelines in Oncology-Antiemesis(Version 1.2014) and Economics of 5-HT_3 Receptor Antagonists in Preventing Nausea and Vomiting

目的评价《NCCN止吐临床实践指南(v1.2014)》依从性及5-HT_3受体拮抗剂预防呕吐的经济性。方法选取泰兴市人民医院2014年6月1日至2014年12月31日放化疗期间使用5-HT_3受体拮抗剂的乳腺癌患者175例。依据《NCCN止吐临床实践指南(v1.2014)》评价指南的依从性,计算不同医疗保险下,患者使用5-HT_3受体拮抗剂的日费用,以评价患者用药的经济性。结果 5-HT_3受体拮抗剂应用指征掌握上,171例符合《NCCN止吐临床实践指南(v1.2014)》用药指征,占97.71%;76例选用的5-HT_3受体拮抗剂品种符合《NCCN止吐临床实践指南(v1.2014)》推荐,占43.43%;116例用药时机适当,占66.29%;140例止吐药物联用适当,占80%。75例预防呕吐方案日费用较低,符合首选方案,占42.86%;100例日费用较高,占57.14%。结论我院肿瘤科、放疗科医生对《NCCN止吐临床实践指南(v1.2014)》用药指征、给药时机掌握较好,但5-HT_3受体拮抗剂日费用高者所占比例较高。医生需要结合患者收入水平、医疗保险类别,选用日费用较低的预防呕吐用药方案。

Objective To evaluate the compliance to NCCN Clinical Practice Guidelines in OncologyAntiemesis（Version 1.2014） and the economics of 5-HT_3 receptor antagonists in preventing nausea and vomiting. Methods We selected 175 breast cancer patients who used 5-HT_3 receptor antagonists to prevent nausea and vomiting induced by chemotherapy in Taixing People＇s Hospital from June 1, 2014 to December 31, 2014. We evaluated the daily cost of the patients with different medical insurance according to the compliance to NCCN Clinical Practice Guidelines in Oncology-Antiemesis（Version 1.2014） and then evaluated the economics of 5-HT_3 receptor antagonists. Results 97.71%（171/175） patients had the necessity to use 5-HT_3 receptor antagonists; Oncologists selected proper 5-HT_3 receptor antagonists for 43.43%（76/175） patients; the time of medication and the combination medication were proper in 66.29%（116/175） and 80.00%（140/175） patients, respectively. The daily cost of 5-HT_3 receptor antagonists was low in 42.86%（75/175） patients while 57.14%（100/175） patients＇ daily cost was high. Conclusion The oncologists in our hospital know NCCN Clinical Practice Guidelines in Oncology-Antiemesis（Version 1.2014） very well in necessity and the time of medication, but the daily cost is high for most patients. The oncologists need to select the lower daily cost of treatment regimen for preventing nausea and vomiting according to the patient＇s income level and medical insurance category.