药物流行病学杂志2024,Vol.33Issue(1) :60-67.DOI:10.12173/j.issn.1005-0698.202312072

布地奈德福莫特罗粉吸入剂与沙美特罗替卡松粉吸入剂治疗青少年哮喘的成本-效用分析

Cost-utility analysis of budesonide/formoterol powder inhalation versus salmeterol/fluticasone powder inhalation for asthma in adolescents

沈安乐 吴斌 刘丹 蒋樾廉 吴娟 殷勇 张顺国
药物流行病学杂志2024,Vol.33Issue(1) :60-67.DOI:10.12173/j.issn.1005-0698.202312072

布地奈德福莫特罗粉吸入剂与沙美特罗替卡松粉吸入剂治疗青少年哮喘的成本-效用分析

Cost-utility analysis of budesonide/formoterol powder inhalation versus salmeterol/fluticasone powder inhalation for asthma in adolescents

沈安乐 1吴斌 2刘丹 1蒋樾廉 1吴娟 1殷勇 3张顺国1
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作者信息

  • 1. 上海交通大学医学院附属上海儿童医学中心药剂科(上海 200127)
  • 2. 上海交通大学医学院附属仁济医院药剂科(上海 200127)
  • 3. 上海交通大学医学院附属上海儿童医学中心呼吸科(上海 200127)
  • 折叠

摘要

目的 评价布地奈德福莫特罗粉吸入剂(以下简称"BF")和沙美特罗替卡松粉吸入剂(以下简称"SF")治疗青少年持续性哮喘的经济性,为临床用药和相关决策提供经济学证据和参考.方法 从我国卫生医疗角度出发,基于上海复旦大学附属闵行医院开展的前瞻性队列研究数据构建Markov模型,模型循环周期为7 d,模拟时限为6年,年贴现率为5%.通过查阅相关文献,确定哮喘急性发作比例、治疗成本及健康效用值等数据.以直接医疗成本、质量调整生命年(QALY)和增量成本-效用比(ICUR)作为主要计算结果,应用TreeAge Pro 2022软件进行成本-效用分析,并通过单因素敏感性分析和概率敏感性分析验证基础分析结果的稳健性.结果 与SF组相比,BF组的健康效用多0.002 5QALYs,成本减少7 043.93元,BF组为绝对优势方案.单因素敏感性分析结果显示,SF价格、BF价格和哮喘急性发作风险比(BFvs.SF)为主要的模型敏感因素;概率敏感性分析结果表明,当意愿支付阈值为257 100元/QALY时,BF组具有经济性的概率约为80%.结论 与SF相比,BF对于青少年持续性哮喘是一种更具经济性的治疗方案.

Abstract

Objective To evaluate the cost-effectiveness of budesonide/formoterol powder inhalation(BF)versus salmeterol/fluticasone powder inhalation(SF)for the treatment of persistent asthma in adolescents,and to provide economic evidence and reference for clinical medication and decision-making.Methods From perspective of Chinese healthcare,a Markov model was established based on a prospective cohort study conducted by Shanghai Fudan University Affiliated Minhang Hospital.The cycle length was 7 days,and the time horizon was 6 years.A discount rate of 5%per year was applied.Clinical parameters including asthma acute exacerbation,treatment costs,and health utility values were obtained from relevant literature.The primary outcomes were direct medical costs,quality-adjusted life-years(QALYs),and incremental cost-utility ratio(ICUR).Cost-utility analysis was performed using TreeAge Pro 2022.The one-way sensitivity analysis and probabilistic sensitivity analysis were conducted to validate the robustness of the basic analysis results.Results Compared with SF group,BF group contributed to an incremental QALYs of 0.002 5 and reduced the cost by 7 043.93 yuan,which implied that BF group was a dominating treatment.Results of one-way sensitivity analysis showed that SF price,BF price and Hazard ratio of asthma acute exacerbation(BF vs.SF)were the main sensitivity factors of model.Probabilistic sensitivity analysis demonstrated the probability of BF being cost-effective was about 80%within the willingness to pay threshold of 257 100 yuan/QALY.Conclusions It was found out in this study that BF was a more cost-effective option for the adolescents with persistent asthma compared with SF.

关键词

布地奈德福莫特罗/沙美特罗替卡松/成本-效用分析/哮喘/青少年

Key words

Budesonide/formoterol/Salmeterol/fluticasone/Cost-utility analysis/Asthma/Adolescent

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基金项目

中国医药教育协会专项课题(2022-ZXKT041-08)

出版年

2024
药物流行病学杂志
中国药学会 武汉医药(集团)股份有限公司

药物流行病学杂志

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影响因子:0.746
ISSN:1005-0698
参考文献量28
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