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標題: | Cost-effectiveness of Gemcitabine Plus Modern Radiotherapy in Locally Advanced Pancreatic Cancer |
作者: | Leung, Henry W. C. Chan, Agnes L. F. Muo, Chih-Hsin |
貢獻者: | China Med Univ, An Nan Hosp, Dept Radiat Therapy Chia Nan Univ Pharm & Sci, Dept Informat Management China Med Univ, An Nan Hosp, Dept Pharm Chia Nan Univ Pharm & Sci, Dept Pharm China Med Univ Hosp, Management Off Hlth Data |
關鍵字: | cost-effectiveness economic evaluation locally advanced pancreatic cancer stereotactic body radiotherapy |
日期: | 2016-05 |
上傳時間: | 2018-01-18 11:39:09 (UTC+8) |
出版者: | Elsevier |
摘要: | Purpose: The purpose of this study was to evaluate the cost-effectiveness of gemcitabine plus modern radiotherapy versus gemcitabine alone in the treatment of locally advanced pancreatic cancer in Taiwan. Methods: A Markov decision-analytic model was performed to compare the cost-effectiveness of 3 treatment regimens; gemcitabine alone (gem-alone), gemcitabine plus intensity-modulated radiotherapy (gem-IMRT), and gemcitabine plus stereotactic body radiotherapy (gem-SBRT). Patients transitioned between 5 health states: stable disease, local progression, distant metastasis, local and distant metastasis, and death. Findings: The incremental cost-effectiveness ratio for gem-IMRT and gem-SBRT compared with gem alone were NT$27,120,168 and NT$2,145,683 per quality-adjusted life-year gained, respectively. A willingness to pay threshold of 3 times the per capita gross domestic product was adopted according to the definition of the World Health Organization. The Taiwan per capita gross domestic product in 2015 was NT$673,920 (US$22,464; 1 NT$ = US$0.03333 in Taiwan); thus, a threshold was considered as NT $2,021,760 (US$67,392). The Monte-Carlo simulation found that the probability of cost-effectiveness at a willingness to pay threshold of NT$2,021,760 per quality-adjusted life-year was 0% chance for gem-IMRT and 50% for gem-SBRT. Implications: This study indicated that gem-IMRT or gem-SBRT in locally advanced pancreatic cancer is not cost-effective at a willingness to pay as defined by World Health Organization guideline in Taiwan. (C) 2016 Elsevier HS Journals, Inc. All rights reserved. |
關聯: | Clinical Therapeutics, v.38 n.5, pp.1174-1183 |
顯示於類別: | [藥學系(所)] 期刊論文 [資訊管理系] 期刊論文
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