UGT1A1*6/*28 基因分型预防中国结直肠癌患者 FOLFIRI 相关重度中性粒细胞减少的成本效果分析。
Cost-effectiveness analysis of UGT1A1*6/*28 genotyping for preventing FOLFIRI-induced severe neutropenia in Chinese colorectal cancer patients.
机构信息
Department of Pharmacy, Fujian Provincial Hospital, Provincial Clinical Medicine College of Fujian Medical University, Fuzhou 350001, Fujian Province, PR China.
Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, PR China.
出版信息
Pharmacogenomics. 2019 Mar;20(4):241-249. doi: 10.2217/pgs-2018-0138. Epub 2019 Jan 10.
AIM
To assess the cost-effectiveness of UGT1A1*6/*28 genotyping compared with no genotyping or no dose adjustment before irinotecan administration in China.
MATERIALS & METHODS: A decision tree model was developed to evaluate costs and health outcomes represented as quality-adjusted life years gained. Model inputs for the frequency of genotypes, the probability of neutropenia under FOLFIRI chemotherapy and direct costs and utilities were obtained from published sources. One-way sensitivity analyses were performed.
RESULTS
The strategy of genotyping with dose reduction dominated all remaining strategies. Compared with the strategies of no genotyping and genotyping with unchanged dose, it resulted in only marginal quality-adjusted life year increases (0.0011 and 0.0012) but a cost reduction of $651.12 and $805.22 per patient, respectively. One-way sensitivity analyses revealed that the model was relatively robust.
CONCLUSION
UGT1A1*6/*28 genotyping was cost saving for Chinese colorectal cancer patients.
目的
评估 UGT1A1*6/*28 基因分型与中国伊立替康给药前不进行基因分型或不进行剂量调整相比的成本效益。
材料与方法
建立决策树模型，以评估成本和健康结果，表现为获得的质量调整生命年。模型输入包括基因型频率、FOLFIRI 化疗中性粒细胞减少的概率以及直接成本和效用，均来自已发表的来源。进行了单因素敏感性分析。
结果
降低剂量的基因分型策略优于所有其他策略。与不进行基因分型和不改变剂量的基因分型策略相比，它仅导致边际质量调整生命年增加（分别为 0.0011 和 0.0012），但每个患者的成本分别降低了 651.12 美元和 805.22 美元。单因素敏感性分析表明，该模型具有相对的稳健性。
结论
UGT1A1*6/*28 基因分型可为中国结直肠癌患者节省成本。
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