Analysis of the cost effectiveness of concurrent cisplatin-based chemoradiation in cervical cancer: implications from five randomized trials.
Analysis of the cost effectiveness of concurrent cisplatin-based chemoradiation in cervical cancer: implications from five randomized trials.
复制标题
宫颈癌同步顺铂放化疗的成本效益分析：五项随机试验的影响。
作者：
Peter G. Rose;Panos T Lappas
目的
最近的五项III期试验提供了强有力的证据，表明一种新的替代疗法，顺铂为基础的放化疗，在治疗晚期宫颈癌方面比单独使用放射的标准疗法更有效。我们进行了药物经济学分析，以确定是否替代顺铂为基础的放化疗是成本效益相比，标准的治疗，单独使用放射。
方法
使用经济模型，我们将成本应用于这五项随机试验的顺铂为主的放化疗组的资源利用数据。我们研究了以顺铂为基础的放化疗在增加中位生存时间方面的益处。增量成本除以生存差异，以确定每个受益患者的成本。根据公布的和估计的生存数据计算每增加寿命年的增量成本（IC/YLG）。
结果
基于已发表的生存率，顺铂为主的放化疗方案获得的生命年成本从2384美元到28,770美元不等，基于估计生存率，从308美元到3712美元不等。方案成本的变化在很大程度上取决于治疗设置。住院患者顺铂和氟尿嘧啶的每例管理费用为8839美元，而门诊患者为3590美元。
结论
与单纯放射治疗相比，顺铂为主的放化疗（住院和门诊）增加的中位生存成本增加了可接受成本的实质性获益。
PURPOSE
Five recent phase III trials provide strong evidence that a new alternative therapy, cisplatin-based chemoradiation, is more effective than standard therapy using radiation alone in the treatment of advanced cervical cancer. We conducted a pharmacoeconomic analysis to determine whether the alternative cisplatin-based chemoradiation is cost effective as compared with standard therapy using radiation alone.
METHODS
Using an economic model, we applied costs to resource utilization data derived from the cisplatin-based chemoradiation arms of these five randomized trials. We examined the cisplatin-based chemoradiation benefits in terms of increased median survival time. Incremental costs were divided by difference in survival to determine the cost per patient benefited. Incremental cost per year of life gained (IC/YLG) was calculated based on both published and estimated survival figures.
RESULTS
Cost per year of life gained for cisplatin-based chemoradiation regimens varied from $2384 to $28,770 based on published survival and from $308 to $3712 based on estimated survival. Variations in regimen cost were largely dependent on treatment setting. Administration costs per patient for cisplatin and fluorouracil in the inpatient setting were $8839 compared with $3590 in the outpatient setting.
CONCLUSION
The increased median survival cost per year of life gained with cisplatin-based chemoradiation (inpatient and outpatient settings) adds a substantial benefit at an acceptable cost compared with radiation therapy alone.
影响因子：
3.8
作者：
TENGS, TO;ADAMS, ME;GRAHAM, JD
通讯作者：
GRAHAM, JD
影响因子：
158.5
作者：
Keys, HM;Bundy, BN;Gersell, D
通讯作者：
Gersell, D
影响因子：
158.5
作者：
Rose, PG;Bundy, BN;Insalaco, S
通讯作者：
Insalaco, S