卡泊芬净与伏立康唑在中性粒细胞缺乏伴发热患者中初始经验性抗真菌治疗的经济学评价
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篇名: 卡泊芬净与伏立康唑在中性粒细胞缺乏伴发热患者中初始经验性抗真菌治疗的经济学评价
TITLE:
摘要: 目的:对卡泊芬净与伏立康唑在中性粒细胞缺乏伴发热(以下简称“粒缺发热”)患者中初始经验性抗真菌治疗的方案进行经济学评价。方法:基于两项关于卡泊芬净与伏立康唑初始经验性抗真菌治疗粒缺发热的国际多中心临床试验,结合国内临床专家对疾病治疗过程中药物选择方面的意见,构建决策树模型,运用TreeAge Pro 2011软件分析卡泊芬净与伏立康唑作为初始经验性抗真菌药物分别治疗10 d的成本效果。结果:卡泊芬净组患者的直接医疗费用低于伏立康唑组(52 826.71元vs. 58 246.70元),治疗成功率和患者生存率均高于伏立康唑组(分别为33.95% vs. 25.63%、92.36% vs. 91.87%)。无论是以治疗成功率还是以患者生存率为效果指标,卡泊芬净组的成本-效果比均小于伏立康唑组,且增量成本-效果比和敏感度分析结果均证实了此结果。结论:对粒缺发热患者进行初始经验性抗真菌治疗,卡泊芬净比伏立康唑更具有成本效果优势。
ABSTRACT: OBJECTIVE: To evaluate the economics of caspofungin vs. voriconazole in initial empirical antifungal therapy of febrile neutropenia (FN). METHODS: Based on two international multiple center clinical trials about caspofungin vs. voriconazole in initial empirical antifungal therapy of FN, combined with domestic clinical experts’ opinions about  drug selection, a decision tree model was developed. TreeAge Pro 2011 software was used to analyze the cost and effectiveness of 10-day therapy of caspofungin or voriconazole as initial empirical antifungal therapy.  RESULTS: The direct medical cost of caspofungin group was lower than that of voriconazole group (52 826.71 yuan vs. 58 246.70 yuan). The success rate and survival rate were higher than voriconazole group (33.95% vs. 25.63%、92.36% vs. 91.87%). Whether the success rate or the survival rate of patients as the effect indicators, cost-effectiveness ratio of caspofungin group was lower than that of voriconazole group. Moreover, incremental cost effectiveness ratio and sensitivity analysis confirmed this conclusion. CONCLUSIONS: Caspofungin has more advantages than voriconazole in cost and effectiveness as initial empirical antifungal therapy in patients with FN.
期刊: 2017年第28卷第14期
作者: 魏艳,陈英耀,郭祖德
AUTHORS: WEI Yan,CHEN Yingyao,GUO Zude
关键字: 卡泊芬净;伏立康唑;经验性治疗;抗真菌药;中性粒细胞缺乏伴发热;成本-效果分析;决策树模型;药物经济学
KEYWORDS: Caspofungin; Voriconazole; Empirical therapy; Antifungal agent; Febrile?neutropenia; Cost-effectiveness analysis; Decision tree model; Pharmacoeconomic
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