Roungrong Jirapan, Teerawattananon Yot, Chaikledkaew Usa
Health Intervention and Technology Assessment Program, Thailand.
J Med Assoc Thai. 2008 Jun;91 Suppl 2:S119-25.
To conduct a cost-utility analysis on recombinant human erythropoietin (rHuEPO) for treating anemic cancer patients induced by chemotherapy compared to blood transfusion alone under the Thai health care setting.
A health care provider's perspective was used to examine relevant costs and outcomes using the Markov model. Cost data were estimated based on the reference price set by the Ministry of Public Health. The effectiveness data were obtained from a systematic review of published literature. The results were presented in terms of incremental cost-effectiveness ratio (ICER) in Thai Baht per Quality Adjusted Life Years (QALYs) gained. A probabilistic sensitivity analysis method was performed.
The ICERs of rHuEPO compared to blood transfusion alone were 3.7 and 2.7 millions Baht per QALY for patients with hemoglobin less than 8 g/dl and 8-9 g/dl, respectively. The rHuEPO required additional resources (more costly) with less benefit compared to blood transfusion for patients with hemoglobin 9-10 g/dl.
The rHuEPO may be cost-ineffective for the treatment of anemia caused by chemotherapy in cancer patients in Thailand.
在泰国医疗保健环境下,对重组人促红细胞生成素(rHuEPO)与单纯输血治疗化疗所致贫血癌症患者进行成本效用分析。
采用医疗保健提供者的视角,使用马尔可夫模型检查相关成本和结果。成本数据根据公共卫生部设定的参考价格估算。有效性数据来自对已发表文献的系统评价。结果以每获得一个质量调整生命年(QALY)的增量成本效益比(ICER)(以泰铢计)呈现。进行了概率敏感性分析。
对于血红蛋白低于8 g/dl和8 - 9 g/dl的患者,rHuEPO与单纯输血相比的ICER分别为每QALY 370万泰铢和270万泰铢。对于血红蛋白9 - 10 g/dl的患者,与输血相比,rHuEPO需要更多资源(成本更高)且效益更低。
在泰国,rHuEPO治疗癌症患者化疗所致贫血可能成本效益不佳。