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題名 | 某醫院癌症標靶治療藥物使用分析=Analysis of Cancer Targeted Therapy Prescriptions in a Hospital |
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作者 | 鄭吉元; 陳偉立; 陳琦華; 鄧新棠; 張文震; Cheng, Chi-yuan; Chen, Wei-li; Chen, Chi-hua; Deng, Shin-tarng; Chang, Wen-cheng; |
期刊 | 藥學雜誌 |
出版日期 | 20130300 |
卷期 | 29:1=114 2013.03[民102.03] |
頁次 | 頁138-141 |
分類號 | 418.31 |
語文 | chi |
關鍵詞 | 癌症; 標靶治療; 衛生署適應症; 自費; Cancer; Targeted therapy; |
中文摘要 | 背景及目標:癌症標靶治療是現今癌症治療趨勢,各種癌症患者都想嘗試。由於癌症標靶治療藥品單價高,因此對於病人、醫院和政府衛生機關都造成衝擊。有鑑於此,本研究的主要目的即希望了解本院使用這類藥品是否符合衛生署適應症,並將根據分析結果,提供本院檢討使用此類高價藥品流程的參考依據。 方法:本研究採回溯性研究方式,利用電腦資料庫取得院內97年1月至12月癌症標靶治療藥品 (注射及口服共12種) 處方的資料。資料分析將分別就住院及門診病人,視其使用的標靶藥品是否符合當時之衛生署適應症,計算門住診使用不符合衛生署適應症 (“衛不符”) 標靶藥品的百分比,並用卡方檢定分析之。針對“衛不符”標靶藥品,我們將進一步分析其臨床用途、開方科別和檢視其是否符合當時之 FDA 核准適應症。同時我們也將計算病人使用自費標靶藥物的百分比。 結果:97年癌症標靶藥品處方總計16920筆 (住院3745筆、門診13175筆),其前三名依次為 erlotinib (23%)、gefitinib (20%)、imatinib (14%)。分析發現“衛不符”處方共計1328筆 (7.8%);而不符合 FDA 適應症者共計811筆 (4.8%)。“衛不符”標靶藥品前三名依次為 sorafenib、sunitinib、bevacizumab,其“衛不符”最常見的臨床用途:sorafenib 是肝細胞癌,sunitinib 和 bevacizumab 則是非小細胞肺癌。就開方科別來看,開立”衛不符”處方最多的科別,前三名依次為婦癌科、胃腸肝膽科、腫瘤科。又門診病人自費使用癌症標靶藥物共計3570筆處方,占所有門診處方的27% (即約每4個癌症標靶藥品處方中就有1個是以自費開立)。 結論:根據此研究結果,本院使用癌症標靶藥品確實有檢討的必要。 |
英文摘要 | This is a retrospective study of cancer targeted therapy prescriptions in a medical center. Through a survey of computer database, total 16920 (inpatient 3745, outpatient 13175) prescriptions of cancer targeted therapy were analysed between January 2008 and December 2008 in a medical center. The result of analysis showed that the most prescribed targeted therapy drugs for cancer was erlotinib (23%), followed by gefitinib (20%) and imatinib (14%). The percentage of targeted therapy prescriptions which did not meet indications regulated by Department of Health (DOH) and FDA-approved indications was 7.8% and 4.8% respectively. Sorafenib, sunitinib and bevacizumab were the top three drugs of off-label use. The most common off-label indications were hepatocellular carcinoma (HCC) with sorafenib, non-small cell lung cancer with sunitinib and bevacizumab. Prescription of off-label use, in terms of clinical specialty, gynecology department was the most, followed by gastroenterology and oncology department. Total 3570 prescriptions were non-reimbursing in outpatients, accounting for 27% of all outpatient prescriptions of cancer targeted therapy (ie, approximately 1 one fourth). Based on our study result, we should design a system to prescribe these drugs more cost-effectively and appropriately in the future. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。