摘要
目的 评估维立西呱联合标准治疗方案治疗射血分数降低的心力衰竭(HFrEF)的经济性。方法 基于VICTORIA临床试验和相关文献数据构建三状态(包括心力衰竭稳定、心力衰竭住院和死亡状态)Markov模型。模型循环周期为1个月,模拟时限为20年,贴现率为5%。采用1倍我国2021年人均国内生产总值(GDP)作为意愿支付(WTP)阈值,对维立西呱联合标准治疗方案治疗HFrEF的经济性进行成本-效用分析,以质量调整生命年(QALY)和增量成本-效果比(ICER)作为健康产出指标。采用单因素敏感性分析和概率敏感性分析来验证基础分析结果的稳健性。结果 维立西呱联合标准治疗方案相较于标准治疗方案的ICER为444 341.95元/QALY,高于本研究的WTP阈值(80 976元/QALY)。单因素敏感性分析结果显示,两组患者的心血管死亡转移概率对模型的稳健性影响较大,但对基础分析结果影响不大。概率敏感性分析结果显示,在本研究的WTP阈值下,维立西呱联合标准治疗方案更具经济性的概率仅有2.6%。结论 与标准治疗方案相比,HFrEF患者使用维立西呱联合标准治疗方案不具有经济性。
OBJECTIVE To evaluate the cost-effectiveness of vericiguat combined with standard treatment in the treatment of heart failure with reduced ejection fraction(HFrEF).METHODS Based on the results of the VICTORIA trial and related literature,a three-state(including stable state of heart failure,hospitalized state of heart failure and death state)Markov model was constructed.The cycle length was 1 month,the time horizon was 20 years,the discount rate was 5%,and one time China’s per capita gross domestic product(GDP)in 2021 was the willing-to-pay(WTP)threshold.Cost-utility analysis was performed to evaluate the cost-effectiveness of vericiguat combined with standard treatment in the treatment of HFrEF.The output indicators included quality-adjusted life year(QALY)and incremental cost-effectiveness ratio(ICER).The robustness of the results of the basic analysis was verified by one-way sensitivity analysis and probability sensitivity analysis.RESULTS The ICER of vericiguat combined with the standard treatment plan compared to the standard treatment plan alone was 444341.95 yuan/QALY,which was more than WTP of this study(80976 yuan/QALY).One-way sensitivity analyses showed that the probability of cardiovascular death in both groups was the main influencing parameter for the robustness of the model,but they had little influence on the results of the basic analysis.The probabilistic sensitivity analysis displayed that under the WTP threshold of this study,the possibility of vericiguat combined with the standard treatment plan being more cost-effective was 2.6%.CONCLUSIONS Compared with the standard treatment plan,vericiguat combined with the standard treatment plan is not cost-effective in patients with HFrEF.
作者
黎风
何梅
母立峰
杨明
LI Feng;HE Mei;MU Lifeng;YANG Ming(Dept.of Pharmacy,the Affiliated Hospital of North Medical College,Sichuan Nanchong 637000,China)
出处
《中国药房》
CAS
北大核心
2023年第15期1869-1873,共5页
China Pharmacy
基金
南充市社会科学研究“十四五”规划2022年度项目(No.NC22C253)。
