摘要
目的探讨帕立骨化醇和骨化三醇治疗血液透析继发性甲状旁腺功能亢进(SHPT)的成本-效果。方法采用成本-效果分析,将患者分为帕立骨化醇治疗组和骨化三醇对照组,两组均可联合西那卡塞治疗,效果指标为两组患者达标率。直接医疗成本中包括治疗药物和定期检验费用。以增量成本效果比(ICER)作为决策指标,对效果及药品价格进行单因素敏感性分析,采用蒙特卡洛模拟对参数随机抽样进行概率敏感性分析。结果两组治疗有效率分别为88.7%(帕立骨化醇组)和56.5%(骨化三醇组)。成本-效果分析显示与骨化三醇相比,帕立骨化醇治疗SHPT的ICER值为41554.702元(小于1倍中国人均GDP)。单因素敏感性分析显示,帕立骨化醇有效率是对ICER值影响最大的因素。概率敏感性分析结果显示当支付意愿(WTP)大于32500元时,帕立骨化醇更具有成本-效果优势。结论与骨化三醇相比,帕立骨化醇治疗SHPT的临床疗效优势明显。根据WHO一倍人均GDP的判断标准,使用帕立骨化醇具有成本-效果优势。
Objective To investigate the cost-effectiveness of paricalcitol and calcitriol in treating secondary hyperparathyroidism(SHPT)in hemodialysis CKD-MBD patients.Methods By cost-effectiveness analysis,patients were divided into the paricalcitol treatment group and the calcitriol control group,both groups could be treated with cinacalcet,and the effect index was the compliance rate of patients in the two groups.Included in direct medical costs are the cost of medication and periodic examinations.Using Incremental Cost-Effective Ratio(ICER)as a decision-making index,a single-factor sensitivity analysis was performed on efficacy and drug prices,and a probabilistic sensitivity analysis was performed on parameter random sampling by Monte Carlo simulation.Results The effective rates of the two groups were 88.7%(paricalcitol group)and 56.5%(calcitriol group).The cost-effectiveness analysis showed that compared with calcitriol,the ICER value of paricalcitol in treating SHPT was 41554.702 yuan(less than one times China's per capita GDP).Univariate sensitivity analysis showed that the effective rate of paricalcitol was the most influential factor on ICER value.The results of probabilistic sensitivity analysis showed that when the willingness to pay(WTP)was greater than 32,500 yuan,paricalcitol had more cost-effectiveness advantages.Conclusion Compared with calcitriol,paricalcitol's clinical efficacy in treating SHPT is obvious.According to the WHO standard of doubling China's per capita GDP,paricalcitol has a cost-effectiveness advantage.
作者
周健楠
阎亚利
张开绚
武辉燕
关颖卓
雷京红
吴甫民
陈罡
ZHOU Jiannan;YAN Yali;ZHANG Kaixuan;WU Huiyan;GUAN Yingzhuo;LEI Jinghong;WU Fumin;CHEN Gang(Department of Nephrology,Beijing Aerospace General Hospital,Beijing 100076,China;Department of Nephrology,Institute of Materia Medica,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《医药导报》
CAS
北大核心
2023年第8期1222-1227,共6页
Herald of Medicine
