达格列净联合常规心力衰竭治疗方案的药物经济学评价

Pharmacoeconomic Evaluation of Dapagliflozin Combined with Conventional Treatment of Heart Failure

目的 对达格列净联合常规心衰治疗方案进行药物经济学评价。方法 基于达格列净的临床试验,建立常规治疗组和达格列净组(即达格列净联合常规治疗组)治疗心衰的Markov模型,以质量调整生命年(quality-adjustedlifeyears,QALYs)为健康产出指标,以1倍的2019年人均国内生产总值作为意愿支付阈值,使用Markov模型模拟获得2种治疗方案的长期效果与成本,并对成本、效用及贴现进行敏感性分析,并检验结果的稳定性。结果 相比于常规治疗组,达格列净组的增量成本-效用比为8 821.32元/QALY,小于意愿支付阈值,增加的成本可接受。概率敏感性分析显示,达格列净组具有成本-效用的概率是87.4%。结论 达格列净联合常规方案比常规方案治疗心衰患者具有更好的经济学效益。

OBJECTIVE To evaluate the cost-effectiveness of dapagliflozin plus conventional therapy in the treatment of heart failure.METHODS On the basis of the clinical trial of dapagliflozin,the Markov model was established to compare the cost-effectiveness of conventional therapeutic group and dapagliflozin group(dapagliflozin plus conventional group) in heart failure patients.Quality-adjusted life years(QALYs) were employed as the indicator of health outcomes.With a willingness-to-pay threshold of one time of the Chinese per-capita gross domestic product,the long-term effects and costs of two treatment groups were simulated and sensitivity analyses of cost,utlity and discount were performed for testing the stability of results.RESULTS The incremental cost-effectiveness ratio of the dapagliflozin group to conventional group was 8 821.32 yuan/QALY.It was less than willingness-to-pay and the incremental cost was acceptable.The probabilistic sensitivity analysis showed that the probability of cost-utility in the dapagliflozin group was 87.4%.CONCLUSION Compared with conventional therapy,dapagliflozin plus conventional therapy has a better economic in patients with heart failure.