吉西他滨
胰腺癌
医学
质量调整寿命年
肿瘤科
内科学
佐剂
临床试验
马尔可夫模型
成本效益
癌症
马尔可夫链
统计
数学
风险分析(工程)
作者
Wei‐Ting Liao,Jiaxing Huang,Gui‐Qi Zhu,Jing Zhou,Feng Wen,Pengfei Zhang,Kaiyu Zhou,Qiuji Wu,Xinyuan Wang,Hongfeng Gou,Qiu Li
标识
DOI:10.1080/14737167.2020.1677155
摘要
Purpose This study aimed to investigate the cost-effectiveness of adjuvant treatments in resected pancreatic cancer.Methods A Markov model was developed to mimic the disease process of postoperative pancreatic cancer, encompassing three health states (relapse-free survival, recurrent disease, and death). Health outcomes and utility scores were derived from the phase III trial and available literature. Cost data were calculated using standard fee data from the West China Hospital for 2017. One-way sensitivity analyses and probabilistic sensitivity analyses were developed to explore model uncertainty.Results Treatment with S-1 was estimated to yield 1.61 quality-adjusted life-years (QALYs) at a cost of $25,696, whereas treatment with gemcitabine yielded 1.27 QALYs at a cost of $28,930. The incremental cost-effectiveness ratio of S-1 versus gemcitabine was $-9,490 per QALY. Based on the willingness-to-pay threshold of $25,841 per QALY, the net monetary benefit (NMB) was $15,786 for S-1 and $3,727 for gemcitabine, generating the incremental NMB of $12,059. A probabilistic sensitivity analysis revealed that the probabilities of S-1 and gemcitabine being cost-effective were 92% and 8%, respectively. Results were robust to changes in parameters.Conclusion Adjuvant therapy using S-1 is a cost-effective alternative compared to gemcitabine in patients with postoperative pancreatic cancer from the Chinese societal perspective.
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