摘要
目的对恩格列净治疗射血分数降低的心力衰竭(HFrEF)进行药物经济学评价,为临床合理用药和医疗卫生决策提供循证依据。方法运用马尔可夫模型对恩格列净治疗HFrEF的方案进行成本-效果分析,评价标准治疗方案联合恩格列净(恩格列净组)与单用标准治疗方案(标准治疗组)的成本和效果。临床参数来自EMPEROR-Reduced研究,成本和健康效用值数据来自己发表的文献。模型的循环周期为1个月,模拟时间为20年。采用单因素敏感性分析和概率敏感性分析对成本-效果分析的结果进行验证。结果恩格列净组较标准治疗组每增加1个质量调整生命年要多花费37 995.94元,低于1倍2020年中国人均国内生产总值(GDP),即72 447元。单因素敏感性分析结果显示,两组患者的稳定状态住院率是对增量成本-效果比影响最大的因素。概率敏感性分析结果显示,当支付意愿阈值(WTP)取1倍2020年中国人均GDP(72 447元)时,恩格列净组有58.8%的概率具有成本-效果优势;当WTP取3倍2020年中国人均GDP(217 341元)时,恩格列净组有63.8%的概率具有成本-效果优势。结论采用标准治疗方案联合恩格列净治疗HFrEF较单纯采用标准治疗方案更具有成本-效果优势,但经济性概率不高。
OBJECTIVE To conduct the pharmacoeconomic evaluation of empagliflozin in the treatment of heart failure with reduced ejection fraction(HFrEF),and to provide evidence-based reference for rational drug use and medical and healthy decision-making.METHODS A Markov model was used to perform a cost-effectiveness analysis of the regimen of empagliflozin in the treatment of HFrEF,and to evaluate the cost and effectiveness of standard treatment plan plus empagliflozin(empagliflozin group)vs.standard treatment plan(standard treatment group).Clinical parameters were obtained from the EMPEROR-Reduced study;cost and utility data came from the published literatures.The cycle of the model was 1 month and the simulation time was 20 years.Single-factor sensitivity analysis and probability sensitivity analysis were performed to validate the results of cost-effectiveness analysis.RESULTS Compared with the standard treatment group,each additional quality-adjusted life year in the empagliflozin group cost 37995.94 yuan more,which was less than China’s 1 time GDP per capita in 2020(72447 yuan).The results of single factor sensitivity analysis showed that steady-state hospitalization rate of 2 groups was the most important factor affecting the incremental cost-effectiveness ratio.The results of probability sensitivity analysis showed that when the willingness-to-pay threshold(WTP)was 1 time GDP per capita in 2020(72447 yuan),the probability of empagliflozin group with cost-effectiveness advantage was 58.8%;when the WTP was 3 times GDP per capita in 2020(217341 yuan),the probability of empagliflozin group with cost-effectiveness advantage was 63.8%.CONCLUSIONS Compared with standard treatment plan alone,standard treatment plan plus empagliflozin is more cost-effective in the treatment of HFrEF.However,the economic probability is not high.
作者
万一鸣
桑海强
董建增
贾雨晨
马慧慧
江耀辉
WAN Yiming;SANG Haiqiang;DONG Jianzeng;JIA Yuchen;MA Huihui;JIANG Yaohui(Dept.of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国药房》
CAS
北大核心
2022年第1期74-78,共5页
China Pharmacy
基金
国家重点研发计划项目(No.2016YFC1301000)。
关键词
恩格列净
射血分数降低的心力衰竭
成本-效果分析
药物经济学
empagliflozin
heart failure with reduced ejection fraction
cost-effectiveness analysis
pharmacoeconomics
