Cost-effectiveness analysis of adjuvant therapy for node positive breast cancer in Korea: docetaxel, doxorubicin and cyclophosphamide (TAC) versus fluorouracil, doxorubicin and cyclophosphamide (FAC)
Cost-effectiveness analysis of adjuvant therapy for node positive breast cancer in Korea: docetaxel, doxorubicin and cyclophosphamide (TAC) versus fluorouracil, doxorubicin and cyclophosphamide (FAC)
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DOI：
10.1007/s10549-008-0035-0
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发表时间：
2009-04-01
影响因子：
3.8
通讯作者：
Seo, Jae Hong
中科院分区：
文献类型：
--
作者：
Lee, Sang Gyu;Jee, Young Geon;Seo, Jae Hong
背景本研究评估了韩国淋巴结阳性乳腺癌患者初次手术后TAC与FAC相比的增量成本效益（ICER）和成本效用比（ICUR）。材料与方法从韩国国民健康保险和患者的角度，使用马尔可夫模型进行成本-效果分析。该模型允许从初次手术后辅助化疗的第一个周期开始直至死亡进行评估。从临床试验BCIRG 001中获得相关临床数据，并从三家韩国医院获得当地治疗模式和直接医疗费用的数据。结果在寿命范围内，TAC的预期寿命比FAC长0.9年。当成本和效果以5%折现时，ICER为8，025，879韩元（KW，a，非符号6，573）/生命年，ICUR为8，885，794 KW（a，非符号7，277）/QALY。该模型对TAC组接受预防性粒细胞集落刺激因子（G-CSF）的患者百分比最敏感，假设100%时，ICUR为12，119，561 KW（a，无符号9，926）。结论TAC在韩国早期乳腺癌的治疗中具有成本效益。
Background This study evaluated the incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) of TAC compared with FAC following primary surgery for node positive breast cancer patients in Korea. Materials and methods A cost-effectiveness analysis was performed using the Markov model from the combined view of Korean National Health Insurance and patients. The model allowed assessment from the beginning of the first cycle of adjuvant chemotherapy following primary surgery until death. Relevant clinical data were obtained from the clinical trial BCIRG 001 and data for local treatment patterns and direct medical costs were obtained from three Korean hospitals. Results Over a life time horizon, the life expectancy of TAC was 0.9 years longer than that of FAC. The ICER was 8,025,879 Korean won (KW, a,not sign6,573) per life year gained and the ICUR was 8,885,794 KW (a,not sign7,277) per QALY gained when the cost and effectiveness were discounted at 5%. The model was most sensitive to the percent patient receiving prophylactic granulocyte colony stimulating factor (G-CSF) in TAC arm and the ICUR was 12,119,561 KW (a,not sign9,926) when assuming 100%. Conclusions TAC appears to be cost-effective in the management of early breast cancer in Korea.