文章：

泰国政策实施后基于真实世界证据的三期结直肠癌口服化疗成本效用与预算影响分析

Cost–Utility and Budget Impact Analyses of Oral Chemotherapy for Stage III Colorectal Cancer: Real-World Evidence after Policy Implementation in Thailand

原文发布日期：11 October 2023

DOI: 10.3390/cancers15204930

类型: Article

开放获取: 是

英文摘要：

This study conducted a cost–utility analysis and a budget impact analysis (BIA) of outpatient oral chemotherapy versus inpatient intravenous chemotherapy for stage III colorectal cancer (CRC) in Thailand. A Markov model was constructed to estimate the lifetime cost and health outcomes based on a societal perspective. Eight chemotherapy strategies were compared. Clinical and cost data on adjuvant chemotherapy were collected from the medical records of 1747 patients at Siriraj Hospital, Thailand. The cost-effectiveness results were interpreted against a Thai willingness-to-pay threshold of USD 5003/quality-adjusted life year (QALY) gained. A 5-year BIA was performed. Of the eight strategies, CAPOX then FOLFIRI yielded the highest life-year and QALY gains. Its total lifetime cost was also the highest. An incremental cost-effectiveness ratio of CAPOX then FOLFIRI compared to 5FU/LV then FOLFOX, a commonly used regimen USD was 4258 per QALY gained.The BIA showed that when generic drug prices were applied, 5-FU/LV then FOLFOX had the smallest budgetary impact (USD 9.1 million). CAPOX then FOLFIRI required an approximately three times higher budgetary level (USD 25.1 million). CAPOX then FOLFIRI is the best option. It is cost-effective compared with 5-FU/LV then FOLFOX. However, policymakers should consider the relatively high budgetary burden of the CAPOX then FOLFIRI regimen.

摘要翻译： 

本研究对泰国III期结直肠癌患者门诊口服化疗与住院静脉化疗方案进行了成本-效用分析和预算影响分析。基于社会视角构建马尔可夫模型，评估八种化疗策略的终身成本与健康产出。辅助化疗的临床及成本数据来源于泰国诗里拉吉医院1747例患者的医疗记录，成本效益结果以泰国支付意愿阈值5003美元/质量调整生命年作为评价标准，并开展五年期预算影响分析。在八种策略中，CAPOX序贯FOLFIRI方案获得的生命年和质量调整生命年最高，其终身总成本也最高。与常用方案5FU/LV序贯FOLFOX相比，CAPOX序贯FOLFIRI的增量成本效益比为每获得一个质量调整生命年需4258美元。预算影响分析显示，采用仿制药价格时，5-FU/LV序贯FOLFOX方案的预算影响最小（910万美元），而CAPOX序贯FOLFIRI方案的预算需求约为其三倍（2510万美元）。CAPOX序贯FOLFIRI是最佳治疗方案，与5-FU/LV序贯FOLFOX相比具有成本效益优势，但决策者需考虑该方案带来的较高预算负担。

原文链接：

Cost–Utility and Budget Impact Analyses of Oral Chemotherapy for Stage III Colorectal Cancer: Real-World Evidence after Policy Implementation in Thailand