摘要
目的:评价胰岛素专项集采后,对比中国2型糖尿病患者使用德谷门冬双胰岛素、甘精胰岛素U300治疗的长期成本-效果。方法:运用IQVIA CORE糖尿病模型,计算治疗30年德谷门冬双胰岛素和甘精胰岛素U300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、疾病管理和并发症治疗等直接医疗成本。效果数据基于Onishi研究(NCT01272193)、EDITION AP研究(NCT02855684)及其中国亚组结果构建的间接比较。健康产出指标为生命年(life year,LY)与质量调整生命年(quality adjusted life years,QALYs)。使用5%的贴现率对健康产出和成本贴现。通过单因素敏感性分析和概率敏感性分析评价研究结果的稳健性。结果:与甘精胰岛素U300治疗方案相比,德谷门冬双胰岛素治疗可使患者多获得0.152 QALYs(9.336 vs.9.184),并节约直接医疗成本7471元(217709 vs.225180),具有药物经济学优势。一系列单因素敏感性和概率敏感性分析结果验证了结果的稳健性。结论:对于中国2型糖尿病患者,与甘精胰岛素U300的治疗方案相比,德谷门冬双胰岛素可以改善患者健康产出并节约成本,是具有药物经济学优势的治疗方案。
Objective:To evaluate the long-term cost-effect of insulin degludec/insulin aspart(IDegAsp)and insulin glargine U300 after implementingspecial centralized procurement of insulin preparations in patients with type 2 diabetes mellitus from China.Methods:The health outputs and health cost of treating with IDegAsp and insulin glargine U300 for 30 years were calculated by using a IQVIA CORE diabetes model,and the cost-effect analysis was done.The study was based on a health system perspective,and the costs included direct medical costs,such as antihyperglycemic therapy,disease management,and treatment of complications.The effect data were based on indirect comparisons constructed from the results of Onishi study(NCT01272193),the EDITION AP study(NCT02855684)and their Chinese subgroups.The indicators of health outputs included life years(LY)and quality adjusted life years(QALYs).A discount rate of 5%was used to discount health outputs and costs.The robustness of results was evaluated with univariate sensitivity analyses and probabilistic sensitivity analyses.Results:Compared with the regimen of insulin glargine U300,the patients obtained 0.152 QALYs(9.336 vs 9.184)with IDegAsp,and the direct medical costs of 7471 yuan(217709 vs 225180)was saved at the same time,which demonstrated a pharmacoeconomic advantage.A series of univariate sensitivity analyses and probabilistic sensitivity analyses confirmed the robustness of these results.Conclusion:Compared with the treatment regimen of insulin glargine U300,treatment with IDegAsp can improve health outputs and save costs for the patients with type 2 diabetes in China.IDegAsp is a treatment regimen with pharmacoeconomic advantages.
作者
罗琼
胡明
LUO Qiong;HU Ming(West China School of Pharmacy,Sichuan University,Chengdu Sichuan 610041,China)
出处
《药品评价》
CAS
2022年第7期385-391,共7页
Drug Evaluation
关键词
糖尿病
2型
德谷门冬双胰岛素
甘精胰岛素U300
专项集采
成本-效果分析
Diabetes mellitus,type 2
Insulin degludec/insulin aspart(IDegAsp)
Insulin glargine U300
Special centralized procurement
Cost-effect analysis
