基于Markov模型的2种治疗慢性乙型肝炎药物经济学评价

Economic Evaluation of Two Kinds of Treatments of Chronic Hepatitis B Based on Markov Model

目的通过建立Markov模型,对替诺福韦艾拉酚胺与替诺福韦酯两种治疗慢性乙型肝炎的一线用药进行药物经济学评价,为临床用药提供循证依据。方法参考药品价格、治疗成本、健康效用值、状态转移概率建立Markov模型,对2种方案的有效性和经济学进行评价,并进行敏感性分析。结果替诺福韦艾拉酚胺组成本为1077244.03元,获得7.89QALYs,替诺福韦酯组成本效果为932456.65元,获得7.48QALYs,增量成本-效果比为353139.95元。结论与替诺福韦酯组比较,替诺福韦艾拉酚胺组能获得更长的生存结果,但其付出的增量成本效果大于3倍人均GDP193932元,不具有经济学效益。

Objective Through the establishment of the Markov model,the pharmacological economic evaluation of tenofovir alafenamide and tenofovir disoproxil for the first-line treatment of chronic hepatitis B was conducted to provide evidence for clinical drug use.Methods The Markov model was established with reference to drug prices,treatment costs,and health utility values.The effectiveness and economics of the two programs were evaluated and sensitivity analysis was performed.Results The composition of tenofovir alafenamide was 1077244.03 yuan,7.89QALYs was obtained,and the effect of tenofovir disoproxil was 932456.65 yuan,and 7.48QALYs was obtained.The incremental cost-effective ratio was 353139.95 yuan.Conclusion Compared with the tenofovir dipivoxil group,the tenofovir alafenamide group can achieve longer survival results,but its incremental cost effect is greater than 3 times GDP per capita,and has no economic benefit.