重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗类风湿关节炎的成本-效用分析

Cost-utility Analysis of Recombinant Human Type Ⅱ Tumor Necrosis Factor Receptor-antibody Fusion Protein in the Treatment of Rheumatoid Arthritis

目的:评价重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(国产商品名:益赛普)治疗类风湿关节炎的经济性。方法:通过文献检索查找国外重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白的"头对头"研究文献或在中国对重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白与英夫利西单抗和阿达木单抗进行比较的文献,对其成本进行本土化转换,并把效果指标转化成质量调整生命年(QALY),然后进行成本-效用分析(CUA)和增量成本-效用分析(ICUR)。结果:得到3篇符合要求的文献,对第1篇Wu B等(2012年)报道内容的转化研究显示,益赛普、英夫利西单抗和阿达木单抗的CUA分别是4.82、3.66、10.46万元/QALY,ICUR分别是11.98、11.64、31.34万元/QALY;对第2篇Santos-Moreno P等(2015年)报道内容的转化研究显示,益赛普、英夫利西单抗和阿达木单抗的CUA分别是9.31、11.82、24.92万元/QALY,ICUR分别是11.75、15.13、32.79万元/QALY;对第3篇Santos-Moreno P等(2016年)报道内容的转化研究显示,益赛普、英夫利西单抗和阿达木单抗的CUA分别是10.70、13.16、27.38万元/QALY,ICUR分别是13.96、17.25、36.98万元/QALY。益赛普的ICUR均小于3倍2015年人均国内生产总值(14.81万元)。结论:从对这3篇文献的研究结果来看,与英夫利西单抗和阿达木单抗比较,益赛普治疗类风湿关节炎具有更高的经济性。

OBJECTIVE:To conduct the economic evaluation of recombinant human typeⅡtumor necrosis factor receptorantibody fusion protein(trade name:Etanercept)in the treatment of rheumatoid arthritis.METHODS:By literature retrieval,foreign literatures about Etanercept“head to head”research or Chinese literatures about the comparison of recombinant human typeⅡtumor necrosis factor receptor-antibody fusion protein with infliximab and adalimumab were collected.The costs were localized,indicators of effectiveness were converted into quality-adjusted life year(QALY),then cost-utility analysis(CUA)and incremental cost-utility ratio(ICUR)were conducted.RESULTS:Three qualified literatures were acquired.The translational research of the first report of WU B and so forth(2012 year)showed that CUA of Etanercept,infliximab and adalimumab were 48.2,36.6 and 104.6 thousand yuan/QALY,and ICUR were 119.8,116.4 and 313.4 thousand yuan/QALY,respectively.The translational research of the second report of Santos-Moreno P and so forth(2015 year)showed that CUA of Etanercept,infliximab and adalimumab were 93.1,118.2 and 249.2 thousand yuan/QALY,and ICUR were 117.5,151.3 and 327.9 thousand yuan/QALY,respectively.The translational research of the third report of Santos-Moreno P and so forth(2016 year)showed that CUA of Etanercept,infliximab and adalimumab were 107.0,131.6 and 273.8 thousand yuan/QALY,and ICUR were 139.6,172.5 and 369.8 thousand yuan/QALY,respectively.ICUR of Etanercept were all smaller than 3 times of GDP 148.1 thousand yuan in 2015.CONCLUSIONS:From the results of the study of these 3 literatures,compared with infliximab and adalimumab,Etanercept shows economy for rheumatoid arthritis.