德谷胰岛素对比甘精胰岛素U300治疗中国2型糖尿病患者的成本效果分析

Cost-effectiveness Analysis of Insulin Degludec Versus Insulin Glargine U300 in the Treatment of Type 2 Diabetes Mellitus Patients in China

目的:评价中国2型糖尿病患者应用德谷胰岛素对比甘精胰岛素U300治疗的长期成本-效果。方法:基于IQVIA CORE糖尿病模型,计算使用德谷胰岛素和甘精胰岛素U300治疗的长期医疗成本和健康产出,并进行增量成本-效果分析。采用卫生体系视角,成本范畴包括降糖治疗成本、疾病管理成本及并发症治疗成本,健康产出指标是生命年与质量调整生命年(quality adjusted life years,QALYs)。模型模拟时间为30年,贴现率为5%。通过单因素敏感性分析和概率敏感性分析评价研究结果的稳健性。结果:与甘精胰岛素U300组比较,德谷胰岛素组的各种慢性并发症累积发病率均有所降低,患者生命年增加0.049年,QALYs增加0.076,直接医疗成本降低24377元,成本节约主要来自降糖治疗成本和并发症治疗成本。敏感性分析验证了研究结果的稳健性。结论:对于中国2型糖尿病患者,与使用甘精胰岛素U300相比,使用德谷胰岛素可以改善患者的长期健康产出并节约直接医疗成本,是成本节约的优势方案。

Objective:To evaluate the long-term cost-effectiveness of insulin degludec(IDeg)versus insulin glargine U300(IGlar U300)in Chinese patients with type 2 diabetes.Methods:Based on the IQVIA CORE diabetes model,the long-term medical costs and health outcomes of treatment with IDeg and IGlar U300 were calculated and an incremental cost-effectiveness analysis was performed.From the perspective of health system,medical costs included hypoglycemic treatment cost,disease management cost and complication treatment cost,and health output indicators were life years and quality adjusted life years(QALYs).The model runs for 30 years at a discount rate of 5%.The robustness of the results was evaluated by one-way sensitivity analysis and probabilistic sensitivity analysis.Results:Compared with the IGlar U300 group,the cumulative incidence of various chronic complications in the IDeg group was reduced,the life year of patients increased by 0.049 years,and the QALYs by 0.076.The direct medical cost was reduced by 24377 yuan,and the cost savings were mainly from the cost of hypoglycemic treatment and the cost of complication treatment.Sensitivity analysis verified the robustness of the results.Conclusions:Compared with IGlar U300,IDeg can improve long-term health outcomes and save direct medical costs in chinese patients with type 2 diabetes,which is a dominant treatment option.