国产依那西普类似物治疗早期活动性类风湿关节炎的药物经济学评价

发布时间：2018-05-30 19:22

本文选题：国产依那西普类似物 + 类风湿关节炎　；参考：《中国医院药学杂志》2017年03期

【摘要】：目的:从社会角度对国产依那西普类似物(益赛普)治疗早期活动性类风湿关节炎(RA)及进入疾病低活动度后的减药方案进行药物经济学评价。方法:根据RA疾病进展的规律,构建含多个健康状态的Markov模型;利用国外相关临床试验估算转移概率;根据某综合医院的收费标准确定治疗方案单周期成本;利用实际临床调查结果确定各状态的健康效用值;对早期活动性RA的甲氨蝶呤(MTX)单药治疗、MTX联合益赛普及达疾病低活动度后的减药方案进行时间跨度为10年的成本效果分析,并对结果进行一元敏感性和概率敏感性分析。结果:Markov模型成本效果分析结果显示MTX联合益赛普达疾病低活动度后继续减半量维持半年为可接受的药物治疗方案。回乘分析结果显示MTX单药治疗的累计成本和健康结果分别为31 598元和6.71QALYs;联合益赛普的累计成本和健康结果分别为79 872元和6.93QALYs,增量成本-效果比为219 427元/QALY;联合益赛普达疾病低活动度后继续减半量维持半年的累计成本和健康结果分别为86 879元和7.18QALYs,增量成本-效果比为117 619元/QALY。一元敏感性分析和概率敏感性分析显示,模型参数的不确定性不影响模型分析结论。结论:从社会角度,在中国对早期活动性RA的治疗方案中,相比单用MTX,联合使用益赛普达疾病低活动度后继续减半量维持半年更具有经济学优势。
[Abstract]:Objective: to evaluate the pharmacoeconomics of the drug reduction regimen after the treatment of early active rheumatoid arthritis (RAA) and the entry of low activity of the disease by domestic etanisepine analogue (Isop) from a social point of view. Methods: according to the law of RA disease progression, the Markov model with multiple health states was constructed, the transfer probability was estimated by foreign clinical trials, and the single cycle cost of treatment scheme was determined according to the charge standard of a general hospital. To determine the health utility value of each state based on the actual clinical investigation results, to analyze the cost effectiveness of MTX in the treatment of early active RA with methotrexate (MTX) in combination with Yiseppe and the drug reduction regimen after reaching low activity of the disease for 10 years, and to analyze the cost and effect of MTX alone in the treatment of early active RA. The results were analyzed by univariate sensitivity and probabilistic sensitivity. Results the results of cost-effect analysis showed that the combination of MTX and Isoproda was an acceptable drug treatment regimen for half a year and then continued to be halved for half a year. The cumulative cost and health result of MTX monotherapy were 31,598 yuan and 6.71QALYs, respectively, and the cumulative cost and health result of the combination were 79,872 yuan and 6.93QALYs, respectively, the incremental cost-effect ratio was 219,427 yuan / QALY. The cumulative cost and health result of the two groups were 86,879 yuan and 7.18 QALYs respectively, and the incremental cost-effect ratio was 117,619 yuan / QALY. Univariate sensitivity analysis and probabilistic sensitivity analysis show that the uncertainty of model parameters does not affect the conclusion of model analysis. Conclusion: in the treatment of early active RA in China, compared with MTX alone, it is more economical to continue to halve the amount of active RA after combined use of Isoproda for half a year.
【作者单位】：苏州大学附属第二医院;
【基金】：苏州市2013年度科技发展计划(应用基础研究-医疗卫生,编号:SYSD2013145)
【分类号】：R593.22

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