ABSTRACT
OBJECTIVE:To evaluate the cost-effectiveness of SOX regimen(tegafur+oxaliplatin)vs. CapeOX regimen (capecitabine+oxaliplatin)in the treatment of metastatic colorectal cancer,and to provide reference for exploring more economical first-line regimen of metastatic colorectal cancer. METHODS:Based on published high-quality Ⅲ-phase randomized controlled trial,Markov model was established according to the process of disease development in patients with metastatic colorectal cancer. The model was divided into progression-free survival state,progressive disease state and death state. Combined with relevant data of our hospital,pharmacoeconomic cost-effectiveness analysis was conducted for SOX regimen and CapeOX regimen. Sensitivity analysis validation model was used to analyze the stability of the model. RESULTS:According to the results of Markov model operation,compared to standard CapeOX regimen,SOX regimen could increase 0.14 QALYs,and cost increased by 35 493.45 yuan;incremental cost-effectiveness ratio was 253 524.64 yuan/QALYs,which was higher than willingness-to-pay(WTP) threshold(168 201.201 yuan/QALYs). Single factor sensitivity analysis showed that cost of oxaliplatin had the most important impact on the result of cost-effectiveness analysis. Probabilistic sensitivity analysis depicted that with the increase of GDP per capita,the probability of SOX regimen with cost-effectiveness would increase. CONCLUSIONS:At present,compared with standard CapeOX regimen,SOX regimen has no cost-effectiveness for metastatic colorectal cancer,which is not recommended as the first choice for first-line treatment of metastatic colorectal cancer.
ABSTRACT
OBJECTIVE:To evaluate the economical efficiency of alogliptin for type 2 diabetes and provide clinical evi-dence for related researches. METHODS:Retrieved from Cochrane Library,Pubmed,EMBase,CNKI,VIP,Wanfang,CBM database up from the start of the database to Mar.,2014,RCTs about alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen in the treatment of type 2 diabetes mellitus were included. Based on the sec-ondary analysis method of literatures,Effectiveness indexes and treatment course were extracted from the literatures,from the perspective of patients,and daily treatment cost was used to calculate the cost;cost-effectiveness analysis was adopted to evalu-ate the economical efficiency of alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen. RESULTS and CONCLUSIONS:6 literatures which met inclusion criteria were included. When alogliptin com-bined with metformin treatment lasted for 12 weeks,the decrease value of HbA1c as effect index showed poor cost-effective-ness;when treatment course increased to 26 weeks,the rate of qualified HbA1c as effect index showed poor cost-effectiveness. When the price of alogliptin decreased by 10% or the effects of trial group was the upper limit of 95%CI,the cost-effective-ness was superior to metformin regimen group. 12 weeks of alogliptin combined with pioglitazone treatment showed better cost-effectiveness than pioglitazone alone using the decrease value of HbA1c as effect;when treatment course increased to 26 weeks,the treatment showed poor cost-effectiveness;when treatment conrse increased to 26 weeks,using the rate of qualified HbA1c as effect indes,the results of sensitirity analysis showed that cost-effectiveness of trial group was better than that of pio-glitazone alone group as the apper limit of 95% CI. When alogliptin combined voglibose treatment lasted for 12 weeks,the de-crease value of HbA1c as effect index showed superior cost-effectiveness to voglibose regimen group. It is suggested to develop alogliptin pharmacoeconomics research based on RCTs and pharmacoeconomics research about improving diabetes patients’ long-term living quality.