摘要
目的:评价伊伐布雷定治疗我国慢性心力衰竭(CHF)患者的成本与效用。方法:使用Markov模型评价在标准方案中加用伊伐布雷定(简称"伊伐布雷定方案")与标准方案的成本与效用,得到患者的终身总成本和质量调整生命年(QALY)。临床参数来自SHIFT中国亚组研究;与CHF相关的成本和效用数据来自我国国内发表的文献。对成本-效用分析结果进行单因素敏感度分析和概率敏感度分析。结果:与标准方案相比,伊伐布雷定方案可以增加0.30 QALYs,同时总成本增加20 153.70元,其增量成本-效用比为67 189.50元/QALY。概率敏感度分析发现,当支付意愿阈值取我国3倍人均GDP(140 000元/QALY)时,伊伐布雷定方案具有成本效用的概率接近90%。伊伐布雷定方案与标准方案的心血管死亡率风险比是最敏感的模型参数。结论:在我国CHF患者的治疗中加入伊伐布雷定较标准方案更具有成本效用。
OBJECTIVE： To evaluate the cost and utility of ivabradine in the treatment of chronic heart failure （CHF） patients in China. METHODS： The cost and utility of standard plan plus ivabradine （called ＂ivabradine plan＂ for short） vs. standard plan were evaluated by Markov model, and lifetime total costs and quality adjusted life years （QALYs） were obtained. The clinical pa- rameters were obtained from SHIFT China subgroup study; cost and utility data related to CHF came from domestic published liter- atures. Single-factor sensitivity analysis and probability sensitivity analysis were performed to test cost-utility analysis. RESULTS： Compared with standard plan, ivabradine plan could increase 0.30 QALYs; at the same time, the total cost increased by 20 153.70 yuan, and the incremental cost-utility ratio was 67 189.50 yuan/QALY. Probability sensitivity analysis showed that the probability of ivabradine plan with cost and utility was 90% when pay threshold was 3 times GDP per capita （140 000 yuan/QALY）. The cardio- vascular mortality risk ratio of ivabradine plan to standard plan was most sensitive model parameters. CONCLUSIONS： Compared with standard plan, additional use of ivabradine in the therapy for China CHF patients shows cost and utility.
出处
《中国药房》
CAS
北大核心
2017年第32期4470-4474,共5页
China Pharmacy
基金
上海市卫生计生系统重要薄弱学科建设计划项目(No.2016ZB0304)
