| 引用本文: |
何江江,卢宪中,何达,等.非小细胞肺癌靶向治疗前间变淋巴瘤激酶伴随诊断方法的经济学分析[J].中国卫生经济,2017,(1):40-43.[点击复制] |
.Economic analysis of ALK related companion diagnosis methods before the targeted therapy for non-small cell lung cancer[J].CHINESE HEALTH ECONOMICS,2017,(1):40-43.[点击复制] |
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| 摘要: |
| 目的：对非小细胞肺癌(NSCLC)患者进行个体化医疗，分析采用各种检测方法分类诊断后指导靶向治疗的健康结果与经济性。方法：建立决策树模型，分别模拟3组10万名NSCLC患者队列用国内指南推荐的3种间变淋巴瘤激酶(ALK)确诊检测方法(FISH、Ventana IHC和RT-PCR)，阳性者使用克唑替尼作为一线治疗，计算5年内发生的医疗成本和获得的健康效果，然后进行成本效果分析；临床和经济学结果的数据主要来源于文献报告。结果：以2014年3倍上海人均GDP为阈值(292,110元人民币)，Ventana IHC指导用药组相较PCR组成本更低，效果更好，因此Ventana IHC组处于优势地位； FISH组相较于Ventana IHC组的ICER为1,091,727元/QALY，远大于阈值，故Ventana IHC组比FISH组更具有成本效果。结论：在3种诊断ALK的检测方法中，建议优先将Ventan IHC伴随诊断方法纳入NSCLC靶向治疗的疾病管理方案。 |
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| Economic analysis of ALK related companion diagnosis methods before the targeted therapy for non-small cell lung cancer |
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| Abstract: |
| Objective: To analyze the health outcomes, cost and cost effectiveness of using testing methods to categorize patients with non-small cell lung cancer and guide targeted therapy. Method: Decision tree model was built to simulate that 3 groups of 100000 NSCLC patients respectively applied 3 ALK testing methods (FISH, Ventana IHC, and RT-PCR) recommended by China guideline and were treated with Crizotinib as first line if ALK positive. Medical cost occurred and health outcomes acquired in 5 years were calculated to carry out cost effectiveness analysis. Clinical and economic data were mainly retrieved from literature summary. Result: With 3 times of Shanghai GDP per capita (2014) as threshold (CNY292,110), Ventana IHC guided therapy group is less costly and more effective compared with PCR group; the ICER of FISH group versus Ventana IHC group was CNY1,091,727 /QALY, far more than the threshold, so Ventana IHC group was more cost effective than FISH group. Conclusion: Among 3 ALK testing methods, we suggested that Ventana IHC should be optimally selected as the companion diagnosis guided NSCLC targeted therapy in the disease management scheme. |
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