乳腺癌辅助化疗后预防性使用乙二醇化重组人粒细胞刺激因子的成本效果分析和对生活质量的影响

Cost-effectiveness and Qol of PEGrhGCSF prophylaxis for breast cancer patients receiving adjuvant chemotherapy

目的探究乳腺癌辅助化疗后预防性使用聚乙二醇化重组人粒细胞刺激因子(PEGrh G-CSF)的成本效果及对生活质量的影响。方法本研究是一项前瞻性队列研究。纳入我科乳腺癌辅助化疗的患者,根据是否预防性使用PEG-rhG-CSF分组,并进行血常规监测。比较两组化疗间期重度粒细胞减少发生率、延迟化疗率、成本费用指标及生活质量,计算增量成本效果比(Incremental cost benefit ratio,ICER)。结果共256例患者纳入分析。与对照组相比,PEG-rhGCSF组重度中性粒细胞减少和延迟化疗的发生率较低,生理状况方面生活质量更好,总费用稍高,针对重度粒细胞减少发生率和延迟化疗率的ICER分别为25.32元/1%和24.45元/1%。结论乳腺癌辅助化疗后预防性使用PEG-rhG-CSF效果良好并提高生活质量,性价比较高。

Objective To analyze the cost-effectiveness of PEGrhGCSF prophylaxis for breast cancer patients receiving adjuvant chemotherapy and its effect on quality of life(Qol).Methods This is a prospective cohort study.The breast cancer patients receiving adjuvant chemotherapy in our department were included and grouped by whether PEGrhGCSF was used or not.Complete blood count was monitored during chemotherapy cycle.Medical related bills were recorded and Qol was evaluated using FACT-B questionnaire.The rates of severe neutropenia and delay of next chemotherapy,medical related cost and Qol were compared between groups.Incremental cost benefit ratio(ICER)was calculated.Results Totally256 patients were included in analysis.Compared with control group,PEG-rhG-CSF group had lower rates of severe neutropenia(9.3%vs.20.6%,P=0.030)and delay of next chemotherapy(5.2%vs.15.9%,P=0.010),and better Qol in physical well-being scale.The total cost was higher in PEG-rhG-CSF group,but the difference was not statistically significant(2102.95 CNY vs.1816.85 CNY,P=0.31).The ICERs for severe neutropenia and delay of next chemotherapy were 25.32 CNY/1%and 24.45 CNY/1%,respectively.Conclusion PEGrhGCSF prophylaxis for breast cancer patients receiving adjuvant chemotherapy was cost-effective and associated with better Qol.