Pharmacoeconomic Study on 3 Chemotherapy Regimens for Advanced Pancreatic Cancer in China Based on Markov Model / 中国药房

ABSTRACT

OBJECTIVE:To evaluate the economical efficiency of gemcitabine(G),gemcitabine combined with oxaliplatin (GM),gemcitabine combined with S-1(GS)in the treatment of advanced pancreatic cancer(APC). METHODS:From the perspective of patients,Markov model was constructed to calculate long-term cost and health outcomes of 3 chemotherapy regimens in Chinese APC patients aged 18-75 old. Cost-effectiveness analysis were used to determine the economic level according to willingness-to-pay(WTP). The sensitivity analysis was conducted for cost,effectiveness and other indexes. RESULTS:The results of cost-effectiveness analysis showed that the cost effectiveness ratio(C/E)of G regimen in the treatment of advanced pancreatic cancer was 145 228.52 yuan/12.26 QALMs;C/E of the GM regimen was 154 783.88 yuan/11.39 QALMs;C/E of GS regimen was 315 485.28 yuan/23.26 QALMs;and the G regimen was the best option. The incremental cost-effectiveness(ICER)of GS and G regimen was 15 479.64,exceeded the WTP(12 563 yuan)set in this sutdy,while ICER of GM and G regimen was -10 999.89, and the GM regimen was absolutely inferior. Results of sensitivity analysis showed that ICER of G regimen vs. GM regimen was unstable and influenced greatly by the parameters of the model. Results of ICER analysis of G regimen vs. GS regimen and GM regimen vs. GS regimen kept stable. Compared to GS regimen,G regimen showed cost-effectiveness characteristics and GM regimen showed economic characteristics;the superiority was relatively less obvious. CONCLUSIONS:Within the level of WTP, cost-effectiveness analysis shows that gemcitabine is the optimal solution. However,sensitivity analysis result can not yet determine which scheme is the best one.