| 摘要: |
| 目的：从医疗保障部门的角度，对曲妥珠单抗辅助治疗早期HER2阳性乳腺癌进行药物经济学评价，为推进乳腺癌规范诊疗和医保政策制定提供依据和参考。方法：基于HERA临床试验，运用Markov模型模拟乳腺癌的发展，比较早期乳腺癌曲妥珠单抗一年辅助治疗组与观察组的成本效用，并进行经济学分析。结果：若采用曲妥珠单抗辅助治疗后，患者的期望生存年、质量调整生命年将分别延长4.30年、2.86年，延长一年所需增加的医疗费用分别为96,334元、144,936元。结论：在湖北省使用曲妥珠单抗辅助治疗早期HER2阳性乳腺癌具有较好的成本效用，湖北省或经济发展水平相当及较高的省市医保部门可以考虑将曲妥珠单抗纳入到医保目录。 |
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| An Economic Evaluation of Trastuzumab in the Adjuvant Treatment for Early HER2-Positive Breast Cancer |
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| Abstract: |
| Objective From the perspective of a China health insurance system, through geting an economic evaluation of Trastuzumab in the Adjuvant Treatment for early HER2-positive breast cancer, to promote breast cancer specification and provide the reference for diagnosis and treatment and health care policies.Methods A Markov health-state transition model was constructed to simulate the natural development of breast cancer based on HERceptin Adjuvant (HERA) trial, estimate costs and disease progression over a lifetime perspective with annual transition cycles, and evaluate the cost-effectiveness of 1-year adjuvant trastuzumab treatment group compared with the standard adjuvant chemotherapy. Results If adopted Trastuzumab by an adjuvant treatment, the expectations of patients survival, quality adjusted life years up to 4.30 years and 2.86 years respectively, extended by a year needed to increase medical costs 96334 yuan, 144936 yuan respectively. Conclusion In hubei province, the results suggest that the 1-year adjuvant trastuzumabtreatment is cost-effective. Hubei or other other provinces and cities that have higher or equal economy development level can consider let trastuzumab into the medical insurance directory. |
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