摘要
目的:评价基础胰岛素控制不佳的2型糖尿病患者使用德谷门冬双胰岛素,对比甘精胰岛素联合门冬胰岛素治疗的短期成本-效果。方法:使用短期成本效果DACE模型计算德谷门冬双胰岛素和甘精胰岛素联合门冬胰岛素治疗基础胰岛素控制不佳的2型糖尿病患者2年的健康产出和卫生成本,并进行成本-效果分析。研究基于卫生体系角度,成本包括降糖治疗成本及相关的低血糖治疗、自我血糖监测(SMBG)等直接医疗成本,效果数据来自已发表的NCT02906917试验和其他文献,采用质量调整生命年(QALYs)表示。并采用单因素敏感性分析和概率敏感性分析评价结果的稳定性。结果:与甘精胰岛素联合门冬胰岛素治疗方案相比,德谷门冬双胰岛素治疗可使患者多获得0.0288 QALYs(1.4617 vs.1.4329),并节约直接医疗成本19748元(22722 vs.42470),费用节约主要来自降糖治疗费用的节约,其中胰岛素、SMBG及针头费用分别节约11863元、5388元、2230元。敏感性分析显示结果稳定可靠。结论:对于基础胰岛素控制不佳的2型糖尿病患者,与甘精胰岛素联合门冬胰岛素的治疗方案相比,使用德谷门冬双胰岛素可改善患者健康产出并节约成本,更具有药物经济学优势。
Objective:To evaluate the short-term cost effectiveness of insulin degludec/insulin aspart(IDegAsp)versus insulin glargine(IGlar)U100 combined with insulin aspart(IAsp)in the treatment of patients with type 2 diabetes mellitus(T2 DM)with inadequately controlled on basal insulin.Methods:Based on DACE model,the 2-year cost and health output of IDegAsp and IGlar+IAsp treatment was calculated,and cost-effectiveness analysis was performed,from the perspective of Chinese healthcare system.Costs including treatment cost,hypoglycemic cost and self monitoring blood glucose(SMBG)cost,clinical effect data were derived from the published NCT02906917 trial and other literature.The health output indicators used quality-adjusted life years(QALYs).And one-way and probabilistic sensitivity analyses were conducted to access the robustness of results.Results:Compared with the IGlar and IAsp,treatment with IDegAsp was associated with an improvement of 0.0288(1.4617 vs.1.4329)QALYs over a 2-year time horizon,and saved 19748(22722 vs.42470)yuan for total cost.Cost savings were primarily driven by insulin cost(11863 yuan),SMBG cost(5388 yuan),and needle cost(2230 yuan).Sensitivity analysis showed that this cost-effectiveness analysis was stable and reliable.Conclusion:Compared with IGlar and IAsp,IDegAsp can improve patients’health output and save costs,which has more advantages in pharmacoeconomics in the treatment of T2 DM with inadequate glycaemic control on basal insulin.
作者
罗琼
周黎
胡明
Luo Qiong;Zhou Li;Hu Ming(West China School of Pharmacy,Sichuan University,Chengdu 610041 China)
出处
《药物流行病学杂志》
CAS
2022年第7期481-485,共5页
Chinese Journal of Pharmacoepidemiology
