吉非替尼治疗非小细胞肺癌药物经济学评价

Pharmacoeconomic evaluation of gefitinib in the treatment of non-small cell lung cancer

目的从医疗保险管理方并兼顾全社会的角度,对湖北省城乡居民非小细胞肺癌靶向药物吉非替尼与卡铂+紫杉醇两种治疗方式进行药物经济学评价。方法以IPASS试验结果为药物效用评价依据,以武汉市5所医院平均治疗成本为成本评价依据,对两种治疗方式进行增量成本效用评价并进行预算影响分析。结果表皮生长因子受体(EGFR)阳性吉非替尼治疗组相对于卡铂+紫杉醇治疗其总生存期增量成本为0.98倍人均GDP,生命质量调整后总生存期增量成本为0.61倍人均GDP;EGFR阴性组总体生存期低于对照组。结论对于EGFR阳性患者,吉非替尼符合药物经济学评价推荐标准,建议将吉非替尼纳入医疗保险支付范围,并严格将EGFR检测阳性作为医保支付前置条件。

Objective To make a pharmacoeconomic evaluation of gefitinib and carboplatin plus paclitaxel in treating non-small cell lung cancer considering the medical insurance management,and the whole society in Hubei province.Methods IPASS test results were taken as the treatments utility evidence,corresponding medical expense by the survey in Wuhan five hospitals as the cost.Incremental cost-utility analysis was done by their Epidermal Growth Factor Receptor(EGFR)mutation.Results The incremental cost of the treated by gefitinib was 0.98 times to the per capital GDP by their overall survival(OS),0.61 times to the per capital GDP by their quality of life adjusted OS in the EGFR positive group.The OS was lower treated by gefitinib than that of control group in the EGFR negative group.Conclusion Gefitinib met the recommended criteria for pharmacoeconomic evaluation to EGFR positive patients.It is suggested that gefitinib be included in medical insurance payments,and the EGFR mutation test was strongly recommended before they be treated with gefitinib.