中期肝细胞癌放射性栓塞治疗的成本效益分析
Cost-effectiveness analysis of treatments involving radioembolization in intermediate-stage hepatocellular carcinoma.
作者信息
Rognoni Carla, Ciani Oriana, Sommariva Silvia, Tarricone Rosanna
机构信息
Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University, Via Roentgen 1, 20136, Milan, Italy.
Evidence Synthesis & Modelling for Health Improvement (ESMI), University of Exeter Medical School, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK.
出版信息
J Comp Eff Res. 2018 Mar;7(3):209-221. doi: 10.2217/cer-2017-0050. Epub 2017 Dec 12.
AIM
We evaluated two treatment sequences, transarterial radioembolization followed by transarterial chemoembolization and possibly sorafenib (=TTS) versus transarterial radioembolization followed by sorafenib alone (=TS), to identify the most cost-effective pathway to treat intermediate-stage hepatocellular carcinoma from the Italian healthcare system perspective.
MATERIALS & METHODS: A Markov model was developed to project costs and health outcomes for TTS and TS over a lifetime horizon. Data available at three hospitals in Italy were collected. Healthcare resource utilization was derived from standard clinical protocols. Costs were obtained from official regional tariffs.
RESULTS & CONCLUSION: Taking into consideration 16 patients for TTS and 22 patients for TS pathways, the TTS sequence provided a dominant strategy in comparison to TS. Further evidence is desirable to confirm these results.
目的
我们评估了两种治疗方案，即经动脉放射性栓塞术序贯经动脉化疗栓塞术并可能联合索拉非尼（=TTS）与经动脉放射性栓塞术序贯单纯索拉非尼治疗（=TS），以从意大利医疗保健系统的角度确定治疗中期肝细胞癌最具成本效益的途径。
材料与方法
构建了一个马尔可夫模型，以预测TTS和TS在患者一生期间的成本和健康结果。收集了意大利三家医院的可用数据。医疗资源利用情况源自标准临床方案。成本则根据官方地区收费标准获取。
结果与结论
考虑到TTS方案涉及16例患者，TS方案涉及22例患者，与TS相比，TTS方案提供了一种优势策略。需要进一步的证据来证实这些结果。
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