聚乙二醇干扰素治疗不同基因型慢性丙型肝炎的药物经济学评价

Pharmacoeconomics evaluation of pegylated interferon for treating different genotypes of chronic hepatitis C

目的:评价与普通干扰素相比,聚乙二醇干扰素α-2a对于不同基因型的中国慢性丙型肝炎患者的经济性。方法:将慢性丙型肝炎患者分为基因1型和非基因1型,分别构建疾病进展Markov模型,比较聚乙二醇干扰素α-2a和普通干扰素的长期成本-效用,并对结果进行敏感性分析。结果:与普通干扰素相比,聚乙二醇干扰素α-2a对于基因1型患者成本更低(183 631.14元vs 212 703.42元)、效用更高(14.06QALY vs 12.32 QALY),聚乙二醇干扰素α-2a更具有经济性;对于非基因1型患者,聚乙二醇干扰素α-2a成本更高(112 770.18元vs 111 025.80元)、效用更高(15.01 QALY vs 14.51 QALY),增量成本-效用比3 488.76元/QALY(低于中国阈值),聚乙二醇干扰素α-2a更具有经济性。敏感性分析与基础分析一致。结论:对于不同基因型中国慢性丙型肝炎患者,聚乙二醇干扰素α-2a均为更经济的治疗方案。

Objective： To evaluate the pharmacoeconomics of pegylated interferon α-2a and interferon based on Chinese patients with different genotypes of chronic hepatitis C. Methods： The chronic hepatitis C patients were divided into genotype 1 and non-genotype 1. Markov models were built,respectively,to simulate developmental process of chronic hepatitis C in Chinese patients. We evaluated the cost and utility of pegylated interferon α-2a and interferon by running 50 cycles of the models,and carried out sensitivity analysis. Results：Cost-utility analysis results showed that for patients with genotype 1 chronic hepatitis C,pegylated interferon α-2a had lower cost（ 183 631. 14 RMB vs 212 703. 42 RMB） and higher utility（ 14. 06 QALY vs 12. 32 QALY）,which proved that pegylated interferon α-2a was cost-effective. With regard to non-genotype 1 patients,pegylated interferonα-2a had higher cost（ 112 770. 18 RMB vs 111 025. 80 RMB） and higher utility（ 15. 01 QALY vs 14. 51 QALY）,and the incremental cost-utility ratio was 3 488. 76 RMB/QALY（ lower than Chinese threshold）,so pegylated interferon α-2a was cost-effective. In the sensitivity analysis,the results were similar with base case analysis.Conclusion： Pegylated interferon α-2a is more cost-effctive than interferon for patients with both genotype 1 and non-genotype 1 chronic hepatitis C in China.