不同胰高糖素样肽-1受体激动剂在中国2型糖尿病患者达到治疗目标的短期成本分析

Different glucagon like peptide-1 receptor agonists have achieved therapeutic goals in Chinese patients with type 2 diabetes:Short term cost analysis

目的本研究评价一年的时间内,在中国医疗保健体系内使用不同胰高糖素样肽-1受体激动剂(GLP-1RA)对中国2型糖尿病患者实现HbA1c治疗目标和减重的相对成本。方法使用SUSTAIN3、SUSTAIN7和SUSTAIN10的研究结果,分析达到血糖控制、不增加体重和低血糖发生结果相关的单终点和复合终点的患者比例。根据患者比例计算达到临床治疗目标所需要的人数、年成本和相对成本。计算成本依据患者使用药物的年度成本,以2022年中国医保定价RMB(CN)表示。结果司美格鲁肽更有效地使患者达到每个终点和复合终点,达到临床治疗目标所需要的人数(NNT)更少。达到HbA1c<7%目标艾塞那肽缓释剂、度拉糖肽、利拉鲁肽控制成本分别是司美格鲁肽的4.77,1.64,2.53倍;而达到HbA1c<7%无低血糖和体重增加目标分别是司美格鲁肽的6.27,1.74,2.89倍。结论在中国治疗2型糖尿病患者方面,与艾塞那肽缓释剂、度拉糖肽、利拉鲁肽相比,司美格鲁肽具有更好的性价比。

Objective This study evaluated the effect of different glucagon like peptide-1 receptor agonists(GLP-1RA)on type 2 diabetes patients in China within one year HbA1c treatment goals and relative control costs per patient for weight loss.Methods The proportion of patients who achieved single and composite endpoints related to blood glucose control,no weight gain,and hypoglycemic outcomes was obtained from SUSTAIN3,SUSTAIN7,and SUSTAIN10 studies;Calculate the number of people,annual cost,and relative control cost required to achieve clinical treatment goals based on the proportion of patients.The cost calculation is based on the annual cost of medication used by patients,expressed in 2022 Chinese medical insurance pricing RMB(CN).Results Smegglutide is more effective in achieving each endpoint and composite endpoint in patients,with fewer people(NNT)required to achieve clinical treatment goals.The cost of achieving the HbA1c<7%target of Esenatide sustained-release agent,Dulaglutide,and Liraglutide is 4.77,1.64,2.53 times higher than that of Smeglutide,respectively;The goals of achieving HbA1c<7%without hypoglycemia and weight gain were respectively 6.25,1.74,2.89 for smeagllutide.Conclusion Smeglutide is more cost-effective than exenatide,dulaglutide and lilalutide in the treatment of type 2 diabetes patients in China.