摘要
目的评价他克莫司常释胶囊与缓释胶囊预防肝移植术后排斥反应的成本-效果。方法选取首都医科大学附属北京友谊医院肝移植门诊2016年1月1日至2023年6月30日收治的肝移植术后患者1520例。其中,1031例患者术后口服常释胶囊,489例患者口服缓释胶囊,并在此基础上加用吗替麦考酚酯胶囊(用法用量相同)行免疫抑制治疗。利用TreeAge Pro 2021软件构建Markov模型,研究时限设为30年。以我国医疗卫生体系视角收集成本(直接医疗成本)及效果参数,对缓释胶囊和常释胶囊预防肝移植术后排斥反应的成本-效果进行分析,并通过单因素敏感性分析和概率敏感性分析验证模型。结果与常释胶囊比较,缓释胶囊的增量成本-效果比(ICER)为159357.86元/质量调整生命年(QALY),小于意愿支付阈值(25.7094万元)。缓释胶囊的价格、贴现率和常释胶囊的价格对模型结果影响较大。肝移植术后30年,缓释胶囊具有成本-效果的概率为63.72%。结论肝移植术后30年时限内,与常释胶囊比较,缓释胶囊预防肝移植术后排斥反应更有药物经济学优势。
Objective To evaluate the cost-effectiveness of tacrolimus regular-release capsules and sustained-release capsules for prevention of the rejection after liver transplantation.Methods A total of 1520 patients underwent liver transplantation admitted to the Outpatient Department of Liver Transplantation in the Beijing Friendship Hospital,Capital Medical University from January 1,2016 to June 30,2023 were selected,1031 of them took the regular-release capsules orally after surgery,489 took the sustained-release capsules orally,and on this basis,Mycophenolate Mofetil Capsuels(same usage and dosage)were added for immunosuppressive therapy.A Markov model was constructed by the TreeAge Pro 2021 software,with a research period of 30 years.The costs(direct medical costs)and utility parameters were collected based on the China's healthcare system to perform the cost-effectiveness analysis of sustained-release capsules and regular-release capsules for prevention of the rejection after liver transplantation,and the model was verified by the univariate sensitivity analysis and probabilistic sensitivity analysis.Results The incremental cost-effectiveness ratio(ICER)of sustained-release capsules to regular-release capsules was CNY 159357.86/quality-adjusted life year(QALY),which was less than the willingness-to-pay(CNY 257094).The price,discount rate of sustained-release capsules and price of regular-release capsules had a significant effect on the model.The cost-effectiveness probability of sustained-release capsules was 63.72%within 30 years after liver transplantation.Conclusion Within 30 years after liver transplantation,sustained-release capsules have more pharmacoeconomic advantages for prevention of the rejection after liver transplantation than regular-release capsules.
作者
王晓剑
韩宝峰
刘冉佳
崔向丽
WANG Xiaojian;HAN Baofeng;LIU Ranjia;CUI Xiangli(Beijing Friendship Hospital,Capital Medical University,Beijing,China 100050;Obstetrics and Gynecology Hospital of Fudan University,Shanghai,China 200090)
出处
《中国药业》
CAS
2024年第18期113-116,共4页
China Pharmaceuticals
基金
国家卫生健康委医院管理研究所医院药学高质量发展研究项目[NIHAYS2302]。
关键词
肝移植
排斥反应
他克莫司
常释胶囊
缓释胶囊
成本-效果分析
liver transplantation
rejection
tacrolimus
regular-release capsules
sustained-release capsules
cost-effectiveness analysis
