门冬胰岛素30和精蛋白生物合成人胰岛素30R治疗2型糖尿病的成本-效果分析

Cost-Effectiveness Analysis of Insulin Aspart30 Versus Premixed Human Insulin 30/70 in Patients with Type 2 Diabetes in China

目的比较门冬胰岛素30和精蛋白生物合成人胰岛素30R治疗2型糖尿病的经济性,为临床用药选择、药品定价等相关决策提供参考。方法采用二次文献研究,搜集国内外已发表的关于门冬胰岛素30和精蛋白生物合成人胰岛素30R治疗2型糖尿病的有效性的相关文献,并进行汇总、筛选,利用Revman5.2软件对所提取的有效性数据进行Meta分析,在此基础上,对门冬胰岛素30和精蛋白生物合成人胰岛素30R进行成本-效果分析,并进行敏感性分析。结果门冬胰岛素30组和精蛋白生物合成人胰岛素30R组总成本分别为1 665.44元和1 383.86元,Hb A1c分别降低2.46和1.83个单位;针对文献质量、药品价格、疗程、使用剂量及检查成本进行的敏感性分析显示这一结果稳定。结论门冬胰岛素30治疗2型糖尿病的经济性总体上优于精蛋白生物合成人胰岛素30R,更具有临床推广价值,但还需进一步深入研究。

OBJECTIVE To evaluate the cost-effectiveness of insulin aspart30（ BIAsp 30） versus premixed human insulin 30/70 （BHI 30） in patients with type 2 diabetes （T2DM） in China so as to provide a reference for relevant decision of drug selection and drug pricing. METHODS Based on a secondary document study method and literature review both at home and abroad, a summary and screening were made on the safety and effectiveness of BIAsp 30 versus BHI 30 for the treatment among insulin-naive people with T2DM. A Meta-analysis was performed to assess the effectiveness and safety of the selected data by using software RevManS. 2. Then combine the price from the National Development and Reform Commission, National Health and Family Planning Commission to per- form cost-effectiveness analysis from a social prospective. Sensitivity analysis and publication bias were conducted. RESULTS Treat- ment with BIAsp 30 is associated with more cost than BHI 30 （ ￥ 1 665.44 vs ￥ 1 383.86）, and the effectiveness data of BIAsp 30 was higher than BHI 30 （2.46 vs 1.83）. Compared with BHI 30, BIAsp 30 is more efficient in pharmacoeconomic cost-effectiveness anal- ysis, and sensitivity analyses demonstrated robustness of the results. CONCLUSION BIAsp 30 is better than BHI 30 in terms of the economy, but it still needs further research.