黄葵胶囊对比氯沙坦钾片治疗IgA肾病的药物经济学评价

Pharmacoeconomic evaluation of Huangkui capsule versus losartan potassium tablets in the treatment of IgA nephropathy

目的评价黄葵胶囊对比氯沙坦钾片治疗IgA肾病的长期成本-效用。方法以质量调整生命年(QALYs)为效用指标,构建慢性肾脏病1~5期的Markov模型。以1年为周期进行20年Markov队列模拟,计算增量成本-效用比(ICUR),以2020年人均国民生产总值(GDP)作为意愿支付(WTP)阈值进行比较,并进行单因素和概率敏感性分析,以评价黄葵胶囊的长期经济性。结果与氯沙坦钾片比较,黄葵胶囊的ICUR值为36334.47元/QALY,小于WTP阈值,具有经济学优势。单因素敏感性分析结果显示,各参数在一定范围内变化后,黄葵胶囊仍具有经济性。概率敏感性分析显示,当WTP阈值为人均GDP时,黄葵胶囊的可接受概率远高于氯沙坦钾片,表明基线分析结果稳健。结论对于IgA肾病的治疗,黄葵胶囊相比于氯沙坦钾片具有更好的临床疗效和长期经济学优势。

Objective To evaluate the long-term cost-utility of Huangkui capsule compared with losartan potassium tablets in the treatment of IgA nephropathy.Methods Using quality-adjusted life years(QALYs)as the effect index to establish the Markov model of chronic kidney disease in stage 1-5,a 20-year Markov cohort simulation with a cycle of 1 year was carried out to calculate the incremental cost-utility ratio(ICUR).Taking GDP per capita in 2020 as the willingness to pay(WTP)threshold,and one-way and probabilistic sensitivity analysis were carried out to evaluate the long-term economy.Results Compared with losartan potassium tablets,the ICUR of Huangkui capsule was 36334.47 yuan/QALY,which was less than the WTP threshold and had a economic advantage.The results of one-way sensitivity analysis showed that Huangkui capsule was still economical after the parameters changed in a certain range.The probabilistic sensitivity analysis showed that when WTP threshold was GDP per capita,acceptable probability of Huangkui capsule was much higher than that of losartan potassium tablets,indicating that the baseline analysis results were robust.Conclusion Huangkui capsule has better clinical efficacy and long-term economic advantages than losartan potassium tablets in the treatment of IgA nephropathy.