微创医学2023，Vol.18Issue(6)：702-708,7.DOI:10.11864/j.issn.1673.2023.06.07
基于Markov模型探讨射频消融术和开腹肝癌切除术治疗早期原发性肝癌的成本效益
Cost-effectiveness of radiofrequency ablation and open hepatectomy for early-stage primary carcinoma of liver based on Markov model
摘要
Abstract
Objective To compare the cost-effectiveness of radiofrequency ablation(RFA)and open hepatectomy(OH)in the treatment of early-stage primary carcinoma of liver(PCL).Methods From the perspective of medical and health system,according to a randomized controlled clinical trial,the disease progression of patients was classified into three states:stable period,relapse period and death to construct a Markov model.Quality-adjusted life-years(QALY)was used as the output index to calculate the incremental cost-effectiveness ratio and the direct medical cost.The cost data were derived from the median price of medical and health service projects in 8 provinces and cities,and the utility data were derived from published literature.The transition probability of each state is analyzed by using the cohort simulation method,and the incremental cost-utility ratio(ICUR)was calculated for sensitivity analysis to test the stability of the results.Results The 20 cycles of model operation showed that the average life expectancy of RFA group was longer than that of OH group,and the direct medical costs of RFA group and OH group were 408 483 yuan and 1 512 127 yuan,respectively.Compared with the two groups,the benefit value increased by 2.87 QALY,and the incremental cost-benefit ratio was 384 544.94 yuan/QALY.Conclusion The incremental cost-effectiveness ratio of RFA scheme is far below the threshold of willingness to pay of 64 800/QALY.As can be seen,RFA has significant cost-effectiveness advantages in the treatment of early PCL diseases.关键词
原发性肝癌/射频消融术/Markov模型/成本效益Key words
Primary carcinoma of liver/Radiofrequency ablation/Markov model/Cost-effectiveness分类
医药卫生引用本文复制引用
赵斌,黄艳青,郑洋,王佳慧,赵铁建..基于Markov模型探讨射频消融术和开腹肝癌切除术治疗早期原发性肝癌的成本效益[J].微创医学,2023,18(6):702-708,7.基金项目
国家自然科学基金(编号:82204755、81960751) （编号:82204755、81960751）
广西自然科学基金(编号:2020GXNSFBA297094) （编号:2020GXNSFBA297094）
广西中青年教师科研基础能力提升项目(编号:2022KY1667) （编号:2022KY1667）
广西中医药大学赛恩斯新医药学院科研项目(编号:2022CX004、2022MS008、2022QJ001) （编号:2022CX004、2022MS008、2022QJ001）
广西中医药大学赛恩斯新医药学院自治区级大学生创新创业项目(编号:S202213643024) （编号:S202213643024）
广西中医药大学青年基金项目(编号:2022QN008) （编号:2022QN008）
