Methodological Research On Pharmacoeconomic Evaluation Of Gastrointestinal Cancer Based On RWD

At present,pharmacoeconomics has been widely used in the screening,diagnosis and treatment of tumors,cardiovascular diseases,diabetes and other diseases,but related theoretical researches and method applications are less.In the context of the increasing prevalence and mortality of tumors in modern society,physical and economic burden on patients has become increasingly serious.Gastrointestinal tumors(esophageal cancer,gastric cancer,colorectal cancer)are important parts of the global tumor incidence and mortality.The prevention and treatment of gastrointestinal tumors will become the main direction for the betterment of mankind.Patients’ demand for anti-tumor drugs has increased,and the cost of new treatment methods has also increased,but the country’s policy resources are limited,and it is increasingly important to explore more efficient economic evaluation methods.Many researches on the economic evaluation of gastrointestinal tumors were published at home and abroad,but due to the reasons that the data sources are not suitable for local and non-systematic and non-comprehensive evaluation,the research has limitations.Based on this,we used the principles and methods of decision analysis and real-world data to evaluate the economics of seven gastrointestinal cancer chemotherapy regimens from the perspective of the health system.The cost data was sorted according to the electronic system from 2014 to 2017 in the hospital;the WHO solid tumor evaluation standard RECIST1.1 was used to determine the three states(non-progress,progress,and death)in the development of gastrointestinal tumors,and the Markov model was established;The DEALE principle was used to calculate the transition probability of the model;the adverse reaction related costs and occurrence probability were obtained according to the patient’s medication list;since the utility value of the patient cannot be directly obtained in the electronic system,patients in the hospital in 2020 were invited to fill in the questionnaire of the health utility value scale,and the utility value of patients from2014 to 2017 was obtained by establishing the prediction model.For real-world data,we used multiple linear regression methods for subgroup analysis to control confounding factors.For each subgroup,cost-utility analysis was performed,and single-factor sensitivity analysis and probability sensitivity analysis were conducted to test the stability of the model’s output results.We compiled a total of 456 patients with gastrointestinal tumors from 2014 to2017,and obtained questionnaire data of 530 patients in hospital in 2020,and established a stable utility value prediction model.Using multiple linear regression methods,patients with gastrointestinal tumors from 2014 to 2017 were divided into 11 subgroups,and the cost and effect of chemotherapy regimens in each subgroup were different.We initially explored a methodology system for pharmacoeconomic evaluation of chemotherapy regimens for gastrointestinal tumors using real-world data.For retrospective data,a predictive model can be established to predict the utility value of patients with gastrointestinal tumors,and the stability of the model can be tested by changing the number of random partition seeds.Using real-world data for pharmacoeconomic evaluation,subgroup analysis can effectively control confounding factors,and the cost-effectiveness of seven gastrointestinal cancer chemotherapy regimens under different conditions can be obtained,which provides a reference for patients with gastrointestinal cancer to choose chemotherapy regimens,as well as a methodological reference for the decision-making of relevant departments.