醋酸兰瑞肽缓释注射液(预充式)对比注射用醋酸奥曲肽微球治疗肢端肥大症的成本效果分析

Cost-effectiveness of lanreotide ATG versus octreotide for the treatment of acromegaly

目的:分别从中国卫生体系和全社会角度出发,对兰瑞肽-ATG对比奥曲肽微球治疗肢端肥大症的经济性进行评价。方法:通过构建决策树模型模拟两方案的累计成本和质量调整生命年(quality adjusted life years, QALYs),并采用增量成本效果比(incremental cost-effectiveness ratio, ICER)对2种治疗方案的成本效果进行评价。研究时限为1年,并通过单因素敏感性分析和概率敏感性分析验证研究结果的稳健性。结果:在1~3倍GDP为意愿支付值的情况下,和奥曲肽微球相比,兰瑞肽-ATG在方案一(标准剂量维持治疗)和方案二(高剂量EDI维持治疗)中均多获得0.024个QALY且节约医疗成本,具有绝对优势,单因素敏感性分析和概率敏感性分析验证了模型的稳健性。结论:无论是基于中国卫生体系角度还是全社会角度,兰瑞肽-ATG对比奥曲肽微球治疗肢端肥大症在节约医疗成本的同时有更多健康获益,均为绝对优势方案。

OBJECTIVE To evaluate the cost-effectiveness of lanreotide ATG compared with octreotide in the treatment of acromegaly from the perspective of Chinese health system and society.METHODS In this study,a decision tree model was constructed to simulate the cumulative costs and quality-adjusted life years(QALYs)of the two regimens,and the incremental cost-effectiveness ratio(ICER)was used to evaluate the cost effectiveness of the two treatment regimens.Both one-way and probabilistic sensitivity analyses were conducted to test the robustness of the result.RESULTS Compared with octreotide LAR,lanreotide autogel gained 0.024 QALYs with the cost savings of regimen 1(standard-dose maintenance therapy)and regimen 2(high-dose EDI maintenance therapy).One-way sensitivity analysis and probabilistic sensitivity analysis verified the model’s robustness.CONCLUSION Patients treated with lanreotide-ATG gained more health benefits,while saving medical cost.Lanreotide ATG was the dominant treatment strategy compared with octreotide from both of Chinese health system and society perspective.