Objective To explore pharmacoeconomic analysis of chemotherapy regimens of capecitabine or fluorouracil combined with oxaliplatin treating colorectal cancer.Methods Totally 58 colorectal cancer patients' medical records from January to December 2011 were analyzed.The records were divided into capecitabine combined with oxaliplatin group (25 cases,oxaliplatin combined with capecitabine,taken orally capecitabine 1 250 mg/m2,suspended one week after each two weeks treatment) and fluorouracil combined with oxaliplatin group [33 cases,oxaliplatin combined with fluorouracil,intravenous fluorouracil 400 mg/m2 (day 1,2),600 mg/m2 continuous intravenous drip in 22 h (day 3,4),and leucovorin calcium 200 mg/m2 intravenously dripped (2 h)].Each group had three courses of treatment.The curative effects and adverse drug reactions were compared and the pharmacoeconomic value.The expenses were evaluated by the means of minimum cost expenses.Results There were no statistically significant difference on efficiency between capecitabine combined with oxaliplatin group and fluorouracil combined with oxaliplatin group [36.0％ (9/25) vs 30.3％ (10/33),x2 =0.814,P =0.367].The medical cost related to adverse drug reactions,examination,diagnosis,hospitalization,nursing and other western medicines in capecitabine combined with oxaliplatin group was lower than that in fluorouracil combined with oxaliplatin group.The difference between the two groups was statistically significant [6 (6,0) yuan vs 291 (291,0)yuan,(2 139 ±1 366) yuan vs (3 014 ±1 032) yuan,(960 ±551) yuan vs (1 489 ±270) yuan,58(232,174) yuan vs 116 (290,174) yuan,40 (160,120) yuan vs 80(200,120) yuan,36 (150,114) yuan vs 72 (188,116) Yuan,all P ＜ 0.05).The differences of chemotherapy expenses and tradition Chinese medicine expenses of two groups showed no significance (P ＞ 0.05).The difference of western medicine expenses between capecitabine combined with oxaliplatin group [2 625 (8 385,5 760 yuan] and fluorouracil combined with oxaliplatin group [2 880(10 655,7 775 yuan] were statistically significant.The difference of total medical expenses between capecitabine combined with oxaliplatin group(9 441 ± 2 353)yuan and fluorouracil combined with oxaliplatin group (11 927 ± 2 117) yuan was statistically significant(P ＜ 0.05).The rate of neutrophil decrease and gastrointestinal adverse drug reaction in capecitabine combined oxaliplatin group was lower than that in fluorouracil combined with oxaliplatin group.Each difference [8.0％ (2/25) vs 18.2％ (6/33),16.0％ (4/25) vs 30.3％ (10/33),20.0％ (5/25) vs 0,P ＜ 0.05] was statistically difference.Conclusion The scheme of capecitabine combined with oxaliplatin is better than scheme of fluorouracil combined with oxaliplatin from the perspective of the pharmacoeconomics.%目的 对治疗结直肠癌的卡培他滨联合奥沙利铂与氟尿嘧啶联合奥沙利铂化疗方案进行药物经济学评价.方法 收集2011年1-12月58例结直肠癌住院患者病历资料并进行回顾性分析.根据不同治疗方案将结直肠癌化疗患者分为卡培他滨联合奥沙利铂组(25例)和氟尿嘧啶联合奥沙利铂组(33例).2组均使用奥沙利铂,卡培他滨联合奥沙利铂组另口服卡培他滨1 250 mg/m2,连服2周后停药1周;氟尿嘧啶联合奥沙利铂组另加用氟尿嘧啶400 mg/m2静脉注射,第1、2天,600 mg/m2静脉滴注(22 h内),第3、4天,同时静脉滴注(2h内)亚叶酸钙200 mg/m2.均用3个疗程.比较2组的疗效和药品不良反应发生情况,采用最小成本分析法对各项费用进行药物经济学评价.结果 卡培他滨联合奥沙利铂组和氟尿嘧啶联合奥沙利铂组近期有效率差异无统计学意义[36.0％(9/25)比30.3％(10/33),x2=0.814,P =0.367].卡培他滨联合奥沙利铂组药品不良反应治疗药费、其他西药费用、检查费、诊疗费、住院费和护理费均低于氟尿嘧啶联合奥沙利铂组,组间差异均有统计学意义[6(6,0)元比291(291,0)元,(2 139±1 366)元比(3 014±1 032)元,(960±551)元比(1 489±270)元,58(232,174)元比116(290,174)元,40(160,120)元比80(200,120)元,36(150,114)元比72(188,116)元,均P＜0.05];卡培他滨联合奥沙利铂组化疗药费、中药费与氟尿嘧啶联合奥沙利铂组的差异无统计学意义(P＞0.05).卡培他滨联合奥沙利铂组和氟尿嘧啶联合奥沙利铂组总西药费分别为[2 625(8 385,5 760)元]、[2 880(10 655,7 775)元],组间差异有统计学意义(P＜0.05);总医疗费用分别为(9 441 ±2 353)、(11 927±2 117)元,组间差异有统计学意义(P＜0.05).卡培他滨联合奥沙利铂组中性粒细胞降低、胃肠道反应发生率均低于氟尿嘧啶联合奥沙利铂组,手足综合征发生率高于氟尿嘧啶联合奥沙利铂组,组间差异均有统计学意义[8.0％(2/25)比18.2％(6/33),16.0％(4/25)比30.3％(10/33),20.0％(5/25)比0,均P＜0.05].结论 从药物经济学角度看,卡培他滨联合奥沙利铂组方案优于氟尿嘧啶联合奥沙利铂组方案.
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