德谷胰岛素在中国2型糖尿病起始胰岛素治疗中的短期成本-效用分析

A short-term cost-utility analysis of insulin degludec in type 2 diabetes mellitus patients with initiation insulin therapy in China

目的评价德谷胰岛素和甘精胰岛素(100 u·mL-1)在接受基础胰岛素起始治疗的中国2型糖尿病患者中的短期成本-效用。方法应用短期成本-效用DOSE模型,基于中国基础胰岛素临床观察性登记研究中患者低血糖发生率以及公开发表的数据,对比德谷胰岛素和甘精胰岛素短期(1年)的健康结果和经济成本差异。结果与甘精胰岛素相比,德谷胰岛素治疗使每人每年增加0.02质量调整生命年(quality adjusted life year,QALY),直接医疗成本总费用每人每年节省984.36元、治疗药费节省812.12元、严重低血糖治疗费用降低87.52元、自我血糖监测费用降低84.64元。敏感性分析进一步验证了结果的稳健性。结论在中国2型糖尿病起始胰岛素治疗中,与甘精胰岛素相比,德谷胰岛素是成本更低、效用更高的优势方案。

Objective To estimate the short-term cost-utility of insulin degludec(IDeg)versus insulin glargine(IGlar 100 u·mL-1)in patients with type 2 diabetes mellitus receiving initiation insulin in China. Methods Based on the incidence of hypoglycemia and published data in the Chinese basic insulin clinical observational registration researchs,the short-term cost-utility DOSE model was used to compare short-term(1-year)health outcomes and economic costs between IDeg and IGlar. Results Compared with IGlar,IDeg treatment increased the quality adjusted life year(QALY)by 0.02 per person per year,saved 984.36 yuan per person per year in total direct medical cost,812.12 yuan in treatment cost,87.52 yuan in severe hypoglycemia treatment cost and 84.64 yuan in self-monitoring cost.Sensitivity analysis further verifies the robustness of the results. Conclusion Compared with IGlar,IDeg is cheaper and more effective for the type 2 diabetes mellitus patients with initial insulin therapy in China.