Cost-utility of pioglitazone for nondiabetic ischemic stroke or transient ischemic attack with insulin resistance
Objective:To estimate the cost-utility of pioglitazone treatment after nondiabetic stroke or transient ischemic attack(TIA)with insulin resistance.Methods:A short-run decision tree model and a long-run Markov model were developed to determine the cost-utility of pioglitazone treatment versus non-pioglitazone treatment after nondiabetic stroke or TIA.Outcomes,costs,utility and transfer proportion of the model were ccollected from the database and the literature.Short-term and lifetime costs per quality-adjusted life-years(QALYs)gained were estimated.One-way and multivariable probabilistic sensitivity analyses were performed to test the robustness of the results.Results:Comparing with non-pioglitazone treatment,pioglitazone treatment became cost-effective from the tenth year onwards.Pioglitazone treatment led to a lifetime(30-year)gain of 0.129 QALYs at an additional cost of CNY 6 990,yielding an ICER of CNY 54 186 per QALY gained.Probabilistic sensitivity analysis showed that pioglitazone treatment is cost-effective in 99.9%of the simulations at a willingness-to-pay threshold of CNY 243000 per QALY.Conclusion:Pioglitazone treatment is cost-effective for nondiabetic stroke or TIA patients with insulin resistance in China.
NETL
NSTL
万方数据
维普
