Clinical Efficacy And Cost-effectiveness Analysis Of Three Different Chemotherapeutic Regimens In The Treatment Of Multiple Myeloma

ObjectiveTo provides a reference for more rational,effective,economical and safe clinical medication,we analysed treatment and costs of 138 patients who was newly diagnosed of mutiple myeloma in General Hospital of Nanjing Chinese people’s Liberation Army from July 2011 to March 2017,retrospectively,and comparised the differences in clinical efficacy,adverse reactions,cost-effectiveness and survival of the three schemes of VCD,CTD,and BiCTD.Methods138 cases of patients with multiple myeloma were from the Department of Hematology,General Hospital of Nanjing Chinese people’s Liberation Army,according to different chemotherapy regimens were divided into A,B,C three groups,A group was given VCD regimen(bortezomib and cyclophosphamide plus dexamethasone)includes 63 cases,B group accepted BiCTD regimen(c-larithromycin and cyclophosphamide and thalidomide plus dexamethasone)con-tains 44 cases,C group received CTD regimen(cyclophosphamide and thalid-omide plus dexamethasone)comprises 31 cases.The total response rate(OR R),high quality remission rate(sCR+CR+VGPR),complete remission rate(C R),total survival time(OS),progression free survival(PFS)and adverse react-ions were observed in three groups of patients.The cost-effectiveness analysi-s was performed by pharmacoeconomics.SPASS 20 software was used to dea-1 with it.The curative effect is classified as grade Kruskal-Wallis,nonparame-tric test.The treatment cost of each group is measured data.If it is normal distribution,homogeneity of variance and ANOVA is used.Otherwise,nonpara-metric test is used.The grade of adverse reaction is counted data and analyz-ed by contingency table.Survival analysis was conducted by Kaplan-Meier m-ethod,Log-rank test was used for significance test.The difference was statist-ically significant in P<0.05.ResultsThe overall responses rates of group A,B and C were 96.83%,81.82%and 64.52%with significant difference(P<0.001).The high response rates of them were 82.5%、59.09%、32.26%with statistical difference(P<0.001).The infection of group A was greater than other groups,with statistical difference(P=0.048),and the ventosity of group A was higer than group B and C,with statistical difference(P=0.01).The cost-effectiveness ratios of them were 35392.87、20765.12 and 21475.48,respectively.The incremental cost-effectiveness ratios of group A and B were 183933.21 and 22259.09,compared with group C.The result were in accordance with sensitivity test.There was no statistical significance in the total survival and progression free survival of the three groups.ConclusionsClinicial efficacy of group A is the best,but group B had advantages on cost-effectiveness compared with other groups,otherwise,group B had low incidence of adverse drug reaction.From the perspective of safety or therapeutic effect and pharmacoeconomics,BiCTD regimen is better of the treatment of MM.