摘要
目的:评价在德谷门冬双胰岛素医保谈判准入后,口服降糖药控制不佳的中国2型糖尿病患者应用德谷门冬双胰岛素治疗的长期成本-效果。方法:基于IQVIA CORE糖尿病模型,计算德谷门冬双胰岛素和甘精胰岛素治疗30年的成本和健康产出,并进行增量成本-效果分析。研究采用卫生系统视角,成本包括降糖治疗、疾病管理及并发症治疗成本,健康产出指标采用质量调整生命年(QALYs),贴现率使用5%。通过概率敏感性分析评价结果的稳健性。结果:与甘精胰岛素组比较,德谷门冬双胰岛素组的QALYs增加了0.064年(8.285年vs 8.221年),直接总医疗成本减少77567元(232867元vs 310434元)。敏感性分析验证了结果的稳健性。结论:与甘精胰岛素比较,使用德谷门冬双胰岛素治疗口服降糖药控制不佳的中国2型糖尿病患者,可以改善健康产出并节约成本,是经济学更优的治疗方案。
Objective:To evaluate the long-term cost and effect of insulin degludec/insulin aspart(IDegAsp)for the treatment of patients with type 2 diabetes mellitus(T2DM)inadequately controlled with oral antidiabetic drugs(OADs)after its health insurance negotiation access in China.Methods:Based on IQVIA CORE Diabetes Model,the 30-year cost and health output of IDegAsp and insulin glargine(IGlar)treatment was calculated,and incremental cost-effectiveness analysis was performed.The study adopted a health system perspective.The cost included hyperglycemic treatment,disease management,and complication treatment.The health output indicators used quality-adjusted life years(QALYs),and the discount rate was 5%.The robustness of results was evaluated through probability sensitivity analysis.Results:Compared with the IGlar group,QALYs in the IDegAsp increased by 0.064 years(8.285 to 8.221),and the total cost decreased by 77567 yuan(232867 to 310434).Sensitivity analysis verified the robustness of the results.Conclusion:Compared with IGlar,treatment with IDegAsp for poorly controlled oral hypoglycemic agents in Chinese patients with type 2 diabetes can improve health output and save costs,which is a more economical treatment plan.
作者
陶立波
王芳旭
TAO Libo;WANG Fangxu(Department of Health Policy and Management,School of Public Health,Peking University,Beijing 100191,China;Center for Health Policy and Technology Evaluation,Peking University Health Science Center,Beijing 100191,China;Beijing Medical and Health Economic Research Association,Beijing 100012,China)
出处
《药品评价》
CAS
2021年第4期193-196,共4页
Drug Evaluation
关键词
胰岛素
医疗保险
德谷门冬双胰岛素
医保谈判准入
成本-效果
Insulin
Medicare
Insulin degludec/insulin aspart
Health insurance negotiation and access
Cost-effect