厄洛替尼治疗非小细胞肺癌的国际药物经济学综述

International pharmacoeconomics review of erlotinib in the treatment of non-small cell lung cancer

目的:综合评价厄洛替尼用于非小细胞肺癌(non-small cell lung cancer,NSCLC)靶向治疗的国际药物经济学研究,探讨厄洛替尼的临床疗效、成本效益。方法:从MEDLINE,EMBASE等数据库检索有关表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)和治疗NSCLC的抗体类药物经济学分析的英文文献,对文献质量进行评论,系统综述靶向药物治疗NSCLC的药物经济学研究结果。结果:纳入的9篇文献显示,在一线治疗以及维持治疗中,厄洛替尼在质量调整生命年(quality-adjusted life year,QALY)无显著差异的情况下较传统化疗方案的总医疗成本更低;在二线治疗中,厄洛替尼较多西他赛在总医疗成本以及QALYs上都具备优势;在三线治疗中,厄洛替尼较最佳支持治疗效果更好,但成本也更高。结论:厄洛替尼用于NSCLC的临床一线和二线治疗更具成本效益,在维持治疗中需考虑患者的经济能力。

Objective： To evaluate international pharmacoeconomics of erlotinib in the targeted therapy of non-small cell lung cancer（NSCLC） in order to explore clinical efficacy and cost effectiveness of erlotinib.Methods： We retrieved international pharmacoeconomics studies on epidermal growth factor receptor tyrosine kinase（EGFR-TKI） inhibitors and antibody drugs for NSCLC from MEDLINE and EMBASE,and then,reviewed pharmacoeconomics results of targeted drugs for NSCLC. Results： It showed that erlortinib＇s total health care costs was less than traditional chemotherapy,while the quality-adjusted life years（QALYs） were not significantly different in the first-line treatment and maintenance therapies. Erlotinib had more pharmacoeconomics advantage than docetaxel in overall medical costs and QALYs in the second-line therapy. Compared with best supportive care,erlotinib＇s clinical efficacy was better but its cost was higher in the third-line treatment. Conclusion： Erlotinib is cost-effective for NSCLC in the first-line and second-line treatments. Erlotinib＇s cost-effect depends on economic ability of patients in maintenance treatment.