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目的对乳腺癌辅助化学治疗(化疗)方案多西他赛联合多柔比星及环磷酰胺(TAC方案)与氟尿嘧啶联合多柔比星及环磷酰胺(FAC方案)进行药物经济学分析。方法建立Markov模型,对接受TAC与FAC辅助化疗方案的患者进行模拟,综合应用临床试验BCIRG 001研究结果、其他公开发表的文献和某大型综合性医院的病历资料,评价2种方案的成本效果比,并进行敏感度分析。结果TAC组的5年健康结果值为4.043 QALYs,比FAC组多0.078 QALYs;TAC组的成本为104597.23元,比FAC组多4305.50元,增量成本-效果比为55016元/QALY。一元敏感度及概率敏感度分析显示Markov模型对重要参数都较稳定。结论从中国医疗卫生体系角度出发,5年内辅助化疗方案TAC比FAC对早期淋巴结阳性乳腺癌患者更具成本效果比。
OBJECTIVE: To perform pharmacoeconomic analysis of docetaxel combined with doxorubicin and cyclophosphamide (TAC regimen) and fluorouracil combined with doxorubicin and cyclophosphamide (FAC regimen) in breast cancer adjuvant chemotherapy (chemotherapy) regimen. Methods The Markov model was established to simulate the patients receiving TAC and FAC adjuvant chemotherapy. The results of BCIRG 001 clinical trial and other published papers and the medical records of a large general hospital were used to evaluate the cost-effectiveness , And conduct sensitivity analysis. Results The 5-year health outcome of TAC group was 4.043 QALYs, which was 0.078 QALYs more than that of FAC group. The cost of TAC group was 104597.23 yuan, 4305.50 yuan more than FAC group, and the incremental cost-effectiveness ratio was 55016 yuan / QALY. Univariate sensitivity and probability sensitivity analysis show that the Markov model is more stable to important parameters. Conclusions From the perspective of China’s healthcare system, TAC is more cost-effective than FAC in patients with early-stage node-positive breast cancer over 5 years.