理气活血滴丸与雷诺嗪治疗冠心病慢性稳定型心绞痛的药物经济学评价

Pharmacoeconomic Evaluation of LiqiHuoxue Dripping Pills and Ranolazine in the Treatment of Chronic Stable Angina Pectoris

目的本研究从社会角度出发,基于美国医疗环境,通过对理气活血滴丸和雷诺嗪治疗冠心病稳定型心绞痛进行成本-效果分析(Cost-Effectiveness Analysis,CEA),探讨二者长期临床应用的经济学优劣势,为理气活血滴丸在美国上市后的定价作为参考。方法建立马尔可夫(Markov)药物经济学模型,以增量成本-效果比(Incremental Cost Effectiveness Ratios,ICER)和质量调整生命年(Quality-adjusted life years,QALYs)作为衡量指标,比较理气活血滴丸与雷诺嗪的健康产出,拟定理气活血滴丸在美国的上市后价格。结果模拟理气活血滴丸和雷诺嗪持续1年治疗冠心病稳定型心绞痛患者的健康结果,理气活血滴丸组患者的平均QALYs值为0.797,高于雷诺嗪组的0.720。依据美国临床与经济评论研究所推荐的ICER阈值为50000~150000美元/QALY,理气活血滴丸在美国定价范围为135.8美元/盒到245美元/盒。结论当理气活血滴丸在美国定价范围为135.8美元/盒到245美元/盒时,与雷诺嗪相比,具有成本效果优势。

Objective This study conducted a Cost-Effectiveness Analysis(CEA)of LiqiHuoxue Dropping Pills and Ranolazine in the treatment of chronicstable angina pectoris(SAP)based on the US medical environment.Thisstudyaimedto explore the long-term clinical and economic differences between the two drugs,and to provide a reference for the pricing of LiqiHuoxue Dripping Pills in the United States.Methods A Markov pharmacoeconomic model was established.Health outcomes are measured by Quality-adjusted life years(QALYs).The economic evaluation results are expressed using Incremental Cost Effectiveness Ratios(ICER).To compare the health outcomes of LiqiHuoxue Dripping Pills and Ranolazine,formulate the post-marketing price of the theorem of LiqiHuoxue Dripping Pills in the United States.Results When QALYs was used as a measure,the 1-year health outcome of patients with SAP in each treatment regimen was:the average QALYs value of patients in the LiqiHuoxue Dripping Pills was 0.797,which was higher than 0.720 in the ranolazine group.According to the US Institute for Clinical and Economic Review,the ICER threshold is 50,000 to 150,000 US dollars/QALY,Liqi Huoxue Dripping Pills is priced from$135.8/box to$245/box.Conclusion When the price of LiqiHuoxue Dripping Pills is$135.8/box to$245/box in the US,it has a cost-effective advantage compared with ranolazine.