德谷胰岛素治疗中国2型糖尿病患者的成本效用分析

Cost-utility analysis of insulin degludec versus insulin glargine in the treatment of type 2 diabetes mellitus patients in China

目的评价德谷胰岛素治疗中国2型糖尿病(T2DM)患者的经济性。方法基于卫生体系角度,采用IQVIA CORE模型,参照药品是甘精胰岛素U100和甘精胰岛素U300。健康产出指标包括生命年和质量调整生命年(QALY),成本范畴包括降糖治疗成本、疾病管理及并发症治疗成本,其中,胰岛素价格采用国家药品带量集采价格。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U100组相比,德谷胰岛素组的慢性并发症累积发病率有所降低,患者增加0.060 QALY,直接医疗成本增加158元,增量成本效果比(ICER)为2 639元/QALY,低于2021年中国1倍人均国内生产总值。与甘精胰岛素U300组比较,德谷胰岛素组的慢性并发症累积发病率有所降低,患者增加0.085 QALY,直接医疗成本降低1 402元,是绝对优势方案。敏感性分析验证了结果的稳健性。结论对于中国T2DM患者,与使用甘精胰岛素U100和甘精胰岛素U300相比,使用德谷胰岛素均是具有经济性的方案。

Objective To evaluate the cost-utility of insulin degludec(IDeg)versus insulin glargine U100(IGlar U100)and insulin glargine U300(IGlar U300)in Chinese patients with type 2 diabetes.Methods From the perspective of health system,based on the IQVIA CORE diabetes model,the long-term medical costs and health outcomes of treatment with IDeg,IGlar U100 and IGlar U300 were calculated and an incremental cost-effectiveness analysis was performed.Health outcomes included life years and quality adjusted life year(QALY),and medical costs included drug cost,disease management cost and complication treatment cost.The price of insulin adopted the price of national volume-based procurement.The simulation 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 U100 group,the quality of life in IDeg group was gained by 0.060 QALY,the direct medical cost was increased by RMB 158 Yuan,and the ICER was RMB 2639 Yuan/QALY.Compared with the IGlar U300 group,the quality of life in IDeg group was gained by 0.085 QALY,the direct medical cost was reduced by RMB 1402 Yuan.Sensitivity analysis verified the robustness of the results.Conclusions Compared with IGlar U100 and IGlar U300,IDeg was likely to be a cost-effective treatment in Chinese patients with type 2 diabetes mellitus.