药物洗脱支架火鹰(Firehawk)与XIENCE V治疗单支单处冠状动脉病变的卫生经济学评价

Health economic evaluation on domestic Firehawk stent and imported XIENCE V stent in treating patients with single de novo coronary lesions

目的 :从支付方角度,分析国产火鹰(Firehawk)冠状动脉雷帕霉素靶向洗脱支架与进口支架XIENCE V相比的成本效果。方法 :根据TARGET I临床试验的结果构建1年决策树模型,拟合临床转归的健康效果,采用回顾性资料收集方法获取成本数据,进行成本效果分析,而后对结果进行敏感度分析。结果 :在治疗冠状动脉单支单处病变时,如果价格相等,Firehawk支架比XIENCE V支架具有绝对的成本效果(人均多获得0.01个质量调整生命年,少支付医药费1 583元);以3倍人均国内生产GDP作为决策阈值,经单因素敏感度分析显示,Firehawk支架价格只要不高于XIENCE V支架价格(集中采购招标价13 800元)的107%,就比它更有成本效果。结论 :本研究证实国产Firehawk支架在治疗冠状动脉单支单处病变时,比XIENCE V支架更具有成本效果,可替代进口支架,建议在集中招标采购、医保报销目录制定等决策中予以关注。

Objective ：To analyze cost-effectiveness between Firehawk target-eluting and XIENCE V drugeluting stents from the payer＇s perspective. Methods ：This study developed a one-year decision model to compare the health outcome and cost based on TARGET I trail results. The cost data was collected through retrospective way. The sensitivity analysis was conducted. Results ：Compared to XIENCE V,Firehawk has absolute cost-effectiveness（0.01 more quality-adjusted-life year and 1 583 RMB yuan of medical cost saving per patient） in treating patients with single de novo coronary lesions when the stents prices were equal. The sensitivity analysis showed that Firehawk had better cost-effectiveness to XIENCE V if its price was no more than 107% price of XIENCE V（13 800 RMB yuan）,based on the decision making threshold of triple per capita gross domestic product（GDP） per QALY gained. Conclusion ：This research showed that domestic Firehawk stent had better cost effectiveness than imported XIENCE V stent,which is proposed to be preferable considered compared to imported stents in decision making.