摘要
目的评价左心耳封堵术(WATCHMAN)对比华法林预防心房颤动患者血栓栓塞的经济性,为临床合理治疗、药费支付等相关决策提供参考。方法本研究采用回顾性研究设计,从付费者角度出发,基于左心耳封堵术相关随机对照临床试验数据,构建马尔科夫模型,采用成本-效用分析对左心耳封堵术对比华法林预防栓塞的经济性进行评价。结果左心耳封堵术组的卫生总成本为135 212.51元,而华法林组为40 961.06元,左心耳封堵术组治疗终生(30年)人均QALY值为9.640,华法林组终生(30年)人均QALY值为8.653,增量成本效果比(ICER)为95 488.51元/QALY,低于WHO推荐的3倍人均GDP(2015年)的阈值。敏感性分析证明研究结果具有稳定性。结论与华法林组相比,左心耳封堵术预防心房颤动患者血栓栓塞具有经济学优势。
Objective Conduct a Cost-Utility analysis of left atrial appendage closure(LAAC) device to prevent thrombus in the treatment of atrial fibrillation,compared with Warfarin,in China,to provide evidence for relevant medical decision making.Method A Markov model,from a payer perspective,was developed to predict 30-year total cost and QALYs gained for LAAC and warfarin groups.Results The total cost for the LAAC group was $135,212.51 while the total cost for the warfarin group was $40,961.06. The QALYs gained for the LAAC group were 9.640 while the total QALYs gained for the warfarin group was 8.653.The ICER was estimated to be $95,488.51/QALY which was below the ICER threshold of 3 times GDP per capita in China(2015) recommended by WHO.Conclusion Compared with warfarin, LAAC is a cost-effective alternative for preventing thrombus in the treatment of atrial fibrillation in China.
出处
《中国药物经济学》
2017年第11期5-9,共5页
China Journal of Pharmaceutical Economics
关键词
左心耳封堵术
心房颤动
栓塞
成本-效用分析
Left atrial appendage closure
Atrial fibrillation
Thrombus
Cost-utility analysis