由于硬膜外药物给药(ITDD)疗法的初始高成本，本研究调查了过去10年来泰国难治性癌症疼痛管理中ITDD疗法的成本效益和成本效用。回顾性研究在三家大学医院中进行，病例对象为2011年1月至2021年1月期间接受ITDD疗法的癌症疼痛患者。临床结局包括数字评分尺度(NRS)、姑息疗效量表(Palliative Performance Scale)和EQ-5D。还记录了直接医疗和非医疗成本以及间接成本。通过社会经济评估，进行了ITDD疗法与传统疗法(从ITDD疗法之前的患者相同成本推算)的成本效益和成本效用分析。 收纳了20名患者(女性:男性=10:10)，年龄为60±15岁，接受了脊髓内经皮穿刺引流装置(IT port; n = 15)或可编程脊髓内泵(IT pump; n = 5)的植入。ITDD疗法后中位生存时间为78(四分位间距=121-54)天。随访2个月时，IT port每2点NRS改善的增量成本效益比(ICER)为US$2065.36 (CA$2829.54)/每2点NRS改善/终生，低于IT pump患者的ICER (US$5479.26 (CA$7506.58)/每2点NRS改善/终生)与持续传统疗法的比较。与传统治疗相比，IT port相对于获得的治疗效果的成本效益比/QALY为US$93,999.31(CA$128,799.06)/每获得1个QALY，高于泰国的成本效益阈值。 与泰国的生活成本相比，IT port治疗癌症疼痛的成本效益和成本效用相对较高，高于成本效益阈值。有必要进行前瞻性成本分析研究，纳入更多患有不同癌症的患者，研究各种价格下早期ITDD疗法与设备的效益。© 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.

Because of the high initial cost of intrathecal drug delivery (ITDD) therapy, this study investigated the cost-effectiveness and cost-utility of ITDD therapy in refractory cancer pain management in Thailand over the past 10 years.The retrospective study was conducted in patients with cancer pain who underwent ITDD therapy from January 2011 to 2021 at three university hospitals. Clinical outcomes included the numerical rating scale (NRS), Palliative Performance Scale, and the EQ-5D. The direct medical and nonmedical as well as indirect costs were also recorded. Cost-effectiveness and cost-utility analyses were performed comparing ITDD therapy with conventional therapy (extrapolated from costs of the same patient before ITDD therapy) from a societally oriented economic evaluation.Twenty patients (F:M: 10:10) aged 60 ± 15 years who underwent implantation of an intrathecal percutaneous port (IT port; n = 15) or programmable intrathecal pump (IT pump; n = 5) were included. The median survival time was 78 (interquartile range = 121-54) days after ITDD therapy. At 2-month follow-up, the incremental cost-effectiveness ratio (ICER)/pain reduction of an IT port (US$2065.36 (CA$2829.54)/2-point NRS reduction/lifetime) was lower than for patients with an IT pump (US$5479.26 (CA$7506.58)/2-point NRS reduction/lifetime) compared with continued conventional therapy. The ICER/quality-adjusted life years (QALYs) gained for an IT port compared with conventional treatment was US$93,999.31(CA$128,799.06)/QALY gained, which is above the cost-effectiveness threshold for Thailand.The cost-effectiveness and cost-utility of IT port therapy for cancer pain was high relative to the cost of living in Thailand, above the cost-effectiveness threshold. Prospective cost analysis studies enrolling more patients with diverse cancers that investigate the benefit of early ITDD therapy with devices over a range of prices are warranted.© 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.