阿仑膦酸钠预防绝经后妇女骨质疏松性骨折的成本-效用分析

发布时间：2018-06-26 02:22

本文选题：阿仑膦酸钠 + 骨质疏松　；参考：《中国药房》2017年17期

【摘要】：目的:评价阿仑膦酸钠预防绝经后妇女骨质疏松性骨折的经济性,为骨质疏松及骨量低下患者选择经济、有效的药物治疗方案提供参考。方法:选择Markov经济学模型,以基础用药(钙剂与维生素D3)和基础用药联合阿仑膦酸钠的随机对照试验文献数据作为基线数据,使用Tree Age Pro 2011软件进行成本-效用分析。以质量调整生命年(QALY)及增量成本效用比(ICUR)作为经济学评价指标,通过单因素敏感度分析考察所建模型的稳定性。结果:基础用药组的QALY为0.704年,联合用药组的QALY为0.708年,两组间的ICUR为714 252.44。对于髋部骨折后期和发生其他骨折的人群,联合用药组均是高成本、低收益,明显不具有经济学优势;但是对于发生椎体骨折的人群,联合用药组发生骨折的累计概率明显低于基础用药组,两组间的ICUR仅为13 902.17,显示出经济学优势;对于发生髋部骨折的人群,基础用药组和联合用药组发生骨折的累计概率相同,两组间的ICUR为19 109.00,显示出经济学优势;对于发生腕部骨折的人群而言,疗效与经济性有待进一步探讨。结论:对于骨质疏松性骨折的低风险人群使用钙剂和维生素D3来预防骨折更为经济;而对于易发生椎体和髋部骨折的高风险人群,选择阿仑膦酸钠联合基础用药则兼顾了有效性与经济性。
[Abstract]:Objective: to evaluate the economic efficiency of alendronate in preventing postmenopausal women with osteoporotic fracture, and to provide a reference for the choice of economic and effective drug therapy for patients with osteoporosis and low bone mass. Methods: a Markov economic model was used to analyze the cost and utility of basic drugs (calcium and vitamin D3) and alendronate combined with alendronate. The baseline data were analyzed with Tree Age Pro 2011 software. The QALY and ICUR were used as economic evaluation indexes, and the stability of the model was investigated by single factor sensitivity analysis. Results: QALY was 0.704 years in the basic medication group, 0.708 years in the combined medication group, and ICUR was 714 252.44 in the two groups. For the later period of hip fracture and the population with other fractures, the combination treatment group was high cost, low income, obviously no economic advantage, but for the people with vertebral fracture, The cumulative probability of fracture in the combined treatment group was significantly lower than that in the base drug group, and the ICUR between the two groups was only 13 902.17, which showed the advantage of economics. The ICUR of the two groups was 19.109.00, which showed the advantage of economics. Conclusion: it is more economical to use calcium and vitamin D3 to prevent the fracture in the low risk population of osteoporosis fracture, but it is more economical to use calcium and vitamin D 3 in the high risk group of vertebral body and hip fracture. The choice of alendronate combined with basic medication is both effective and economical.
【作者单位】：天津市天津医院药学部;天津医科大学临床医学院;
【分类号】：R580;R683

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