基于Markov模型的利培酮与阿立哌唑治疗精神分裂症的药物经济学评价

Pharmacoeconomic Evaluation of Risperidone and Aripiprazole for Schizophrenia based on Markov Model

目的 运用Markov模型评价利培酮与阿立哌唑治疗精神分裂症的长期经济性。方法 基于公开发表的有关利培酮和阿立哌唑治疗精神分裂症的临床随机对照试验数据,构建两种药物治疗精神分裂症的Markov模型,并设定模型的各个参数。比较两种药物治疗精神分裂症的健康结果和资源消耗,并进行成本-效果分析及敏感性分析。结果 Markov模拟利培酮和阿立哌唑治疗精神分裂症3年,平均花费分别为14 396元和16 147元,分别获得14.03和13.77个质量调整生命年(QALYs),与阿立哌唑治疗方案相比,利培酮治疗方案每多获得一个QALY的成本少1 751元。在药品价格下降10%、20%的情况下,对结果没有影响,利培酮仍为优势方案。结论 与阿立哌唑相比,利培酮治疗方案节省了较多的成本,是临床治疗精神分裂症的优势方案。

Objective To evaluate the long-term economic benefits of risperidone and aripiprazole in the treatment of schizophrenia using markov model.Methods Based on the published data of clinical randomized controlled trials on risperidone and aripiprazole in the treatment of schizophrenia,a Markov model of the treatment of schizophrenia with two drugs was constructed and the parameters of the model were set.The health outcomes and resource consumption of the two drugs for schizophrenia were compared,and cost-effectiveness and sensitivity analyses were performed.Results Markov simulated risperidone and aripiprazole to treat schizophrenia for 3 years,with an average cost of $14 396 and $16 147,respectively,and gained 14.03 and 13.77 quality-adjusted life years(QALYs),respectively.The risperidone treatment regimen cost $1 751 less for each additional QALY received.When the drug price drops by 10% or 20%,there is no effect on the result,and risperidone is still the preferred solution.Conclusion Compared with aripiprazole,the risperidone treatment regimen offers greater cost savings and is a superior regimen for the clinical treatment of schizophrenia.