医保准入后德谷门冬双胰岛素对比甘精胰岛素治疗口服降糖药控制不佳的中国2型糖尿病患者的成本-效果

Cost-effectiveness Analysis of Insulin Degludec/Insulin Aspart Versus Insulin Glargine in Insulin-Naive Type 2 Diabetes Mellitus after Health Insurance Negotiation and Access in China

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.