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美倍非格司亭和重组人粒细胞集落刺激因子用于非小细胞肺癌化疗引起的中性粒细胞减少症一级预防的成本效果分析。

Cost-effectiveness analysis of mecapegfilgrastim and recombinant human granulocyte stimulating factor for primary prophylaxis of chemotherapy-induced neutropenia in non-small cell lung cancer.

出版信息

Int J Clin Pharmacol Ther. 2024 Mar;62(3):115-121. doi: 10.5414/CP204479.

Abstract

OBJECTIVE

To evaluate the efficacy, safety, and economics of mecapegfilgrastim and recombinant human granulocyte colony-stimulating factor (rhG-CSF) in the primary prevention of chemotherapy-related neutropenia in non-small cell lung cancer (NSCLC).

MATERIALS AND METHODS

Data from 181 patients with NSCLC who received intermediate risk chemotherapy were collected from the information system of a tertiary hospital in China. Patients were categorized into two groups: those treated with mecapegfilgrastim (n = 91) and those treated with rhG-CSF (n = 90). The clinical efficacy rates of neutropenia prevention were used as effect indicators, and a cost-effectiveness analysis was conducted from the perspective of the Chinese healthcare system. Logistic regression, generalized linear regression, and bootstrap methods were used for sensitivity analyses.

RESULTS

There was no statistical difference between the mecapegfilgrastim and rhG-CSF groups in clinical efficacy rates (98.9 vs. 97.8%). However, the total cost in the mecapegfilgrastim group was significantly higher than that in the rhG-CSF group (16,341.6 CNY vs. 14,371.1 CNY, p = 0.03). The cost-minimization analysis shows that mecapegfilgrastim is not cost-effective. The sensitivity analyses confirm that these results are robust.

CONCLUSION

Compared with rhG-CSF, mecapegfilgrastim is not a cost-effective strategy for NSCLC patients in neutropenia prevention in China.

摘要

目的

评估麦格司他与重组人粒细胞集落刺激因子(rhG-CSF)在非小细胞肺癌(NSCLC)患者化疗相关中性粒细胞减少症一级预防中的疗效、安全性和经济学效益。

材料与方法

从中国一家三甲医院的信息系统中收集了 181 例接受中危化疗的 NSCLC 患者的数据。将患者分为两组:接受麦格司他治疗(n=91)和 rhG-CSF 治疗(n=90)。以中性粒细胞减少症预防的临床疗效率为效应指标,从中国医疗保健系统的角度进行成本效果分析。采用逻辑回归、广义线性回归和 Bootstrap 方法进行敏感性分析。

结果

麦格司他和 rhG-CSF 组的临床疗效率(98.9% vs. 97.8%)无统计学差异。然而,麦格司他组的总费用明显高于 rhG-CSF 组(16,341.6 CNY 比 14,371.1 CNY,p=0.03)。成本最小化分析显示,麦格司他并不具有经济性。敏感性分析证实了这些结果的稳健性。

结论

与 rhG-CSF 相比,麦格司他在预防中国 NSCLC 患者中性粒细胞减少症方面并非一种具有成本效益的策略。

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