达格列净治疗慢性肾病患者的成本-效用分析

Cost-utility analysis of dapagliflozin in patients with chronic kidney disease

目的:大型随机对照试验已证实达格列净在慢性肾病中的有效性和安全性,因此有必要对达格列净治疗慢性肾病的经济性进行评价.方法:基于支付方角度,利用Markov模型分析加用达格列净治疗慢性肾病的成本效用.Markov模型参数来源于现有临床和经济学文献,循环周期为1年,模拟患者终身的直接医疗费用和质量调整生命年(QALYs).采用单因素敏感性分析和概率敏感性分析评价结果的稳健性.结果:达格列净联合常规治疗组的终身费用为33.81万元,获得13.70 QALYs;常规治疗组的终身费用为37.15万元,获得13.37 QALYs.敏感性分析显示结果具有稳健性.结论:与单纯常规治疗相比,加用达格列净治疗慢性肾病更具有经济性.

Objective:To evaluate the long-term economics of dapagliflozin for chronic kidney disease since a large randomized controlled trial has confirmed the efficacy and safety of dapagliflozin in patients with chronic kidney disease.Therefore it is necessary to evaluate the economic efficacy of dapagliflozin in the treatment of chronic kidney disease.Methods:Based on Markov model,the economics of adding dapagliflozin for chronic kidney disease was evaluated from the payer's perspective.Markov model parameters came from published clinical and economic literature.Model cycle was one year.Simulate lifelong direct medical expenses and quality adjusted life years(QALYs).One-way and probabilistic sensitivity analysis was used to check the robustness.Results:Markov model cohort analysis showed that in the dapagliflozin group,the patients could acquire 13.70 QALYs with 0.3381 million yuan while the conventional group would benefit 13.37 QALYs with 0.3715 million yuan.The sensitive analysis showed that the result was robust.Conclusion:Compared with the conventional treatment,adding dapagliflozin may be a better choice in the long run for chronic kidney disease.