Min Su Hyun, Ko Su Kyoung, Lim Ji Young
Department of Nursing, Inha University, Incheon, Korea.
Taehan Kanho Hakhoe Chi. 2008 Jun;38(3):363-71. doi: 10.4040/jkan.2008.38.3.363.
This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting.
A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted.
Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol.
The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.
本分析旨在评估门诊环境下吉西他滨联合顺铂化疗与传统住院环境下相比,对非小细胞肺癌患者的成本效益。
从社会角度进行成本效益分析。治疗效果以不良事件发生率衡量,从已发表的文献检索及一所大学医院的实证数据中提取。成本包括直接成本和间接成本。直接成本包括住院、门诊就诊和实验室检查。分析中排除了药品成本,因为两种方案的药品成本相同。间接成本包括患者及护理人员的生产力损失。为确定结果的稳健性,对治疗方案进行了敏感性分析。
文献检索显示住院治疗方案和门诊治疗方案的不良反应发生率无差异。因此,本分析为成本最小化分析。门诊环境下一个治疗周期可节省成本555,936韩元。我们的敏感性分析表明,无论治疗方案如何变化,门诊化疗仍显示出成本节省。
与住院化疗相比,门诊吉西他滨联合顺铂化疗可节省成本。更重要的是,门诊化疗在可用床位方面可提高卫生服务资源的利用率。