公共衛生學院: 健康政策與管理研究所指導教授: 楊銘欽劉岡易Liu, Kang-YiKang-YiLiu2017-03-032018-06-292017-03-032018-06-292016http://ntur.lib.ntu.edu.tw//handle/246246/274368目的：本研究使用衛生福利部中央健康保險署之觀點，利用經濟評估方法比較晚期ALK陽性之非小細胞患者接受Crizotinib相較於標準化學治療策略（鉑金類藥物治療組合）之成本效用。 方法：由2007至2013年之全民健康保險研究資料庫百萬抽樣歸人檔獲得晚期非小細胞肺癌病者之真實資料，分析病患接受化學治療之疾病無惡化存活期（Progression-Free Survival, PFS）與整體存活期（Overall Survival, OS），並使用文獻回顧取得之風險比值（Hazard ratio, HR）模擬晚期ALK陽性非小細胞肺癌病患使用新藥Crizotinib及標準化學治療藥物組合策略之無設限存活情形及成本差異後，進行成本效用分析及多維敏感度分析，計算遞增成本效果比值（Incremental Cost-Effectiveness Ratio, ICER）。 結果：晚期ALK基因陽性表現非小細胞肺癌病患使用Crizotinib治療策略相對於標準化學治療策略，每增加一個人年壽命（Life-year, LY）將額外付出新台幣2,565,058.0元，而每增加一個生活品質調整人年（Quality adjusted life-year, QALY）將額外付出新台幣4,698,269.3元。Purpose: This study aimed to estimate the cost-utility of Crizotinib treatment as first-line medication on late stage ALK positive non-small-cell lung cancer patients compare to current chemotherapy from the payer’s perspective in Taiwan. Methods: A cost-utility analysis was conducted using a Markov model from the National Health Insurance Administrative perspective. Real-world data and costs were obtained from National Health Insurance Reasearch Database to calculate the progression-free survival and overall survival of late stage NSCLC patients using chemotherapy as main treatment strategy. Then, hazard ratios from literature review were used to simulate the survival conditions seperately for late stage ALK positive NSCLC patients using Crizotinib treatment or chemotherapy. Results: Compared to chemotherapy, late stage ALK positive NSCLC patients using Crizotinib treatment as first-line medication resulted in gaining 0.807 life-years (LYs) and 0.440 quality-adjusted life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was NT$2,565,058.0 per LY gained and NT$4,698,269.3 per QALY gained.2163030 bytesapplication/pdf論文公開時間: 2021/8/26論文使用權限: 同意無償授權經濟評估成本效用分析非小細胞肺癌間變性淋巴球激?標靶治療Economic evaluationcost-utility analysisnon-small-cell lung cancerALKtargeted-therapy[SDGs]SDG3thesis10.6342/NTU201600890http://ntur.lib.ntu.edu.tw/bitstream/246246/274368/1/ntu-105-R03848027-1.pdf