| 引用本文: | 梁平,王玉栋,白靖,邓淇均,魏宗敏,徐彤,候娟,刘江.贝伐珠单抗联合紫杉醇用于HER-2阴性转移性乳腺癌一线治疗的药物经济学评价[J].中国现代应用药学,2021,38(1):82-86. |
| LIANG Ping,WANG Yudong,BAI Jing,DENG Qijun,WEI Zongmin,XU Tong,HOU Juan,LIU Jiang.Pharmacoeconomic Evaluation of Bevacizumab in Combination with Paclitaxel in the First-line Treatment of Patients with HER-2 Negative Metastatic Breast Cancer[J].Chin J Mod Appl Pharm(中国现代应用药学),2021,38(1):82-86. |
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| 贝伐珠单抗联合紫杉醇用于HER-2阴性转移性乳腺癌一线治疗的药物经济学评价 |
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梁平1, 王玉栋2, 白靖1, 邓淇均1, 魏宗敏1, 徐彤1, 候娟1, 刘江1
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1.河北医科大学第四医院, 药学部, 石家庄 050011;2.河北医科大学第四医院, 肿瘤内科, 石家庄 050011
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| 摘要: |
| 目的 基于卫生服务体系角度评估贝伐珠单抗联合紫杉醇在HER-2阴性转移性乳腺癌（metastatic breast cancer，MBC）中的成本效果。方法 根据E2100试验的疗效和不良事件中的数据，采用动态Markov模型模拟患者终身的直接医疗成本和质量调整生命年（quality-adjusted life years，QALYs）。以增量成本-效果比（incremental cost-effectiveness ratio，ICER）为评价指标，评价贝伐珠单抗联合紫杉醇与紫杉醇治疗MBC方案的优劣，并分析结果敏感度。健康效用来自现有文献，费用从河北医科大学第四医院获取。结果 贝伐珠单抗联合紫杉醇对比紫杉醇提高了0.28 QALYs，成本增加了182 806元，ICER为652 879元/QALY，每增加1年无进展生存期的成本为355 471元。结论 贝伐珠单抗联合紫杉醇能延长HER-2阴性MBC患者的生命年，提高生命质量，同时也增加医疗成本，根据WHO 3倍人均GDP的判断标准，贝伐珠单抗联合紫杉醇用于HER-2阴性MBC的一线治疗不具有成本效果优势。 |
| 关键词: 乳腺癌|成本效果分析|贝伐珠单抗|HER-2阴性转移性乳腺癌|质量调整生命年 |
| DOI：10.13748/j.cnki.issn1007-7693.2021.01.013 |
| 分类号:R956 |
| 基金项目:河北省医学科学研究重点课题计划（20170739） |
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| Pharmacoeconomic Evaluation of Bevacizumab in Combination with Paclitaxel in the First-line Treatment of Patients with HER-2 Negative Metastatic Breast Cancer |
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LIANG Ping1, WANG Yudong2, BAI Jing1, DENG Qijun1, WEI Zongmin1, XU Tong1, HOU Juan1, LIU Jiang1
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1.The Fourth Hospital of Hebei Medical University, Department of Pharmacy, Shijiazhuang 050011, China;2.The Fourth Hospital of Hebei Medical University, Department of Medical Oncology, Shijiazhuang 050011, China
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| Abstract: |
| OBJECTIVE To assess the cost-effectiveness of bevacizumab in combination with paclitaxel in HER-2 negative metastatic breast cancer(MBC) from a health service system perspective. METHODS Based on data from the efficacy and adverse events of the E2100 trial, a dynamic Markov model was used to simulate direct medical costs and quality-adjusted life years(QALYs) over the lifetime of patients. Incremental cost-effectiveness ratio(ICER) was used as an evaluation index to evaluate the advantages and disadvantages of bevacizumab combined with paclitaxel versus paclitaxel in the treatment of metastatic breast cancer, and the sensitivity of the results was analyzed. Health utilities were obtained from existing literature and costs were obtained from The Fourth Hospital of Hebei Medical University. RESULTS Bevacizumab combined with paclitaxel increased 0.28 QALYs compared with paclitaxel, and the cost increased 182 806 yuan, then ICER was 652 879 yuan/QALY, and the cost per additional one-year progression-free survival was 355 471 yuan. CONCLUSION Bevacizumab combined with paclitaxel can prolong the life years of HER-2 negative MBC patients, improve the quality of life, but also increase medical costs. According to the 3 times of GDP per capita judgment criteria of WHO, bevacizumab combined with paclitaxel for first-line treatment of HER-2 negative MBC has no cost-effectiveness advantage. |
| Key words: breast cancer|cost-benefit analysis|bevacizumab|HER-2 negative metastatic breast cancer|quality-adjusted life years |
