伊朗用于治疗急性淋巴细胞白血病儿童的BFM-ALL和UK-ALL方案的成本效益分析
Cost-utility of Protocols of BFM-ALL and UK-ALL for Treatment of Children with Acute Lymphoblastic Leukemia in Iran.
作者信息
Hayati Hadi, Kebriaeezadeh Abbas, Ehsani Mohammad Ali, Nikfar Shekoufeh, Akbari Sari Ali, Mehrvar Azim, Shahgholi Elham
机构信息
Faculty of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran.
Dept. of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Iran J Public Health. 2018 Mar;47(3):407-412.
BACKGROUND
There is a requirement to assess the effectiveness and resources used in two protocols United Kingdom (UK-ALL) and Berlin-Frankfurt-Munster (BFM-ALL) that are most commonly used to treatment of ALL patients by oncologists in Iran. Accordingly, we analyzed the cost of treatment and utility of children treated with two protocols in Iran.
METHODS
The entire medical direct costs of patients in "BFM ALL" protocol and "UK ALL" protocol in multi-centers calculated from Apr 2010 to Jun 2015. For calculating utility and Quality Adjusted Life Year (QALY) of the patients, we used standard questionnaire Health Utilities Index 3 (HUI3). The patients and their parents were interviewed. Data were analyzed using software SPSS18 and EXCEL.
RESULTS
The average direct medical cost for each patient for BFM-ALL was 15026 USD and UK-ALL was 8282 USD which showed a significant difference in the total cost of the treatment in the two protocols (≤0.02). Finally, there was a significant difference in the utility score of the maintenance phase of these two methods (≤0.003).
CONCLUSION
UK-ALL is dominant and BFM protocol is dominated by both sides total costs and utility and QALY. Mainly, more hospital stay in "BFM ALL" protocol is the cause of raised costs in this protocol. Consequently, by considering different QALYs in the methods and low costs in "UK ALL" protocol, "UK ALL" protocol is more preferred.
背景
有必要评估英国（UK-ALL）和柏林-法兰克福-明斯特（BFM-ALL）这两种方案的有效性及所使用的资源，伊朗的肿瘤学家在治疗急性淋巴细胞白血病（ALL）患者时最常使用这两种方案。因此，我们分析了伊朗采用这两种方案治疗儿童的治疗成本和效用。
方法
计算2010年4月至2015年6月期间多中心采用“BFM ALL”方案和“UK ALL”方案治疗患者的全部医疗直接成本。为计算患者的效用和质量调整生命年（QALY），我们使用了标准问卷健康效用指数3（HUI3）。对患者及其父母进行了访谈。使用SPSS18软件和EXCEL对数据进行分析。
结果
BFM-ALL方案每位患者的平均直接医疗成本为15026美元，UK-ALL方案为8282美元，这表明两种方案的治疗总成本存在显著差异（≤0.02）。最后，这两种方法维持阶段的效用评分存在显著差异（≤0.003）。
结论
UK-ALL方案在总成本、效用和QALY方面占主导地位，而BFM方案处于劣势。主要是因为“BFM ALL”方案患者住院时间更长，导致该方案成本增加。因此，考虑到两种方案的QALY不同，且“UK ALL”方案成本较低，“UK ALL”方案更受青睐。
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