关键词: 经济学 , 非小细胞肺, 药物疗法, 癌

Abstract: Objective: To evaluate and compare the costs of four thirdgeneration chemotherapy regimens in advanced nonsmall lung cancer (NSCLC) patients in China. Methods: The Chinese biomedical database (CBMdisc) and Chinese Medical Current Contents (CMCC) were used to search for all literature from the year 1983 to 2005 which conformed to the following key words: vinorelbine, gemcitabine, paclitaxel, docetaxel and cisplatin and NSCLC. The corresponding four combination regimens were summarized and compared in response rate, overall survival and 3/4 degrees of adverse effects. Costminimization analysis was used according to the following cost model: CT（total cost）＝C1 (chemotherapy)＋C2 (drug administration)＋C3 (concomitant medication)＋C4(cost for 3/4 degrees of adverse effects). Sensitivity analyses were performed to quantify the effects of various cost drivers. Results: 18 out of 143 articles were available, and the response rates of the four combination chemotherapies in total for 721 patients were 47.11%, 48.50%, 43.28% and 37.82% (P>0.05) respectively for vinorelbine (NP), gemcitabine (GP), paclitaxel (PC), docetaxel (DC). Costs per cycle were respectively 4322.2RMB (NP), 7420.0 RMB (GP), 8113.8RMB (PC) and 6372.3RMB (DC). C1 covered the largest part in all regimens. Sensitivity analysis presented the conclusion that NP had the lowest cost and was not significantly affected by variance of C2, C3 and C4. Conclusions： Among the four thirdgeneration chemotherapy regimens in NSCLC, NP has the lowest cost, while PC is the most costly. Drug acquisition covers the largest part in all regimens.

Key words: Carcinoma, nonsmall cell lung, Drug therapy, Economics