目的 对卡培他滨治疗晚期转移性结直肠癌进行经济学评价。方法 基于卡培他滨和5-氟尿嘧啶+亚叶酸钙(5-FU+LV)治疗晚期转移性结直肠癌的Meta分析结果,将各个方案的结局终点分别设为缓解、稳定、无效,通过临床调查天津市三级医院相关的医疗服务价格,利用Treeage软件进行决策树的模型建立,最后进行成本-效果分析以及敏感性分析。结果 卡培他滨组的疗效略好于5-FU+LV组,其治疗成本高于5-FU+LV组。通过单因素敏感性分析发现,结局指标稳定,结局未发生逆转。结论 与5-FU+LV方案相比,卡培他滨口服使用方便且临床疗效肯定,尽管直接医疗成本-效果分析发现,其无显著经济学优势,但其间接成本和隐性成本费用低,具有一定的临床推广应用价值。

Objective To evaluate the economic significance of capecitabine in treatment of advanced or metastatic colorectal cancer. Methods Based on Meta-analysis of the clinical efficacy of capecitabine and 5-fluorouracil/leucovorin (5-FU/LV) in treatment of advanced or metastatic colorectal cancer, the outcomes of the end points were set as objective release, stable disease, and progressive disease. The price of medical services in tertiary hospitals in Tianjin was investigated, and the cost-effectiveness analysis was conducted with Treeage decision tree and further sensitivity analysis was carried out. Results The efficacy of capecitabine group was better than that of 5-FU/LV group, however the treatment cost was higher than that of 5-FU/LV group. The single factor sensitivity analysis showed that the outcome indicators were stability and the end was not reversed. Conclusion Compared with the 5-FU/LV regime, capecitabine is easy to taken orally, and the clinical efficacy is sure. Although direct medical cost-effectiveness analysis shows capecitabine has no significant economic advantage, however the indirect costs and intangible costs of capecitabine is lower, which has a certain clinical application value.

"十二五"国家科技支撑计划课题(2013BAI06B04)