Cost-utility analysis of dorzagliatin combined with metformin in the treatment of type 2 diabetes mellitus patients with poor glycemic control with metformin
OBJECTIVE To evaluate the cost-effectiveness of dorzagliatin combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)patients with poor glycemic control with metformin.METHODS A Markov model was established based on a phase Ⅲ randomized controlled trial study of dorzagliatin combined with metformin in the treatment of T2DM.From the perspective of the Chinese health system,cohort simulation was used to predict the long-term cost-utility of each strategy.Using the quality-adjusted life years(QALYs)as the health output indicator,three times the 2022 gross domestic product(GDP)per capita as the willingness-to-pay threshold(WTP),the incremental cost-effectiveness ratio(ICER)was analyzed,then sensitivity analyses and scenario analysis were also performed.RESULTS After simulating 30 years of disease progression,compared with metformin,dorzagliatin combined with metformin reduced the probability of metastasis with complications by 15.1%,and the probability of death by 8.5%,improved cumulative utility by 0.62 QALYs,with an ICER of 235 260.30 yuan/QALY,which was less than the WTP,and an acceptable increase in cost.The results of the single-factor sensitivity analysis showed that the ICER value was greatly affected by the cost of no complications in the intervention group,the utility value of diabetes without complications,and the utility value of diabetes with complications.Probabilistic sensitivity analysis showed that the probability of combination therapy being cost-effective was 68.8%.The results of scenario analysis showed that with the decline in the price of dorzagliatin,the combination therapy had more obvious economic advantages.CONCLUSIONS For T2DM patients with poor glycemic control with metformin alone,the combination of dorzagliatin and metformin has long-term cost-utility advantages,but the economic probability is only close to 70%.
万方数据
维普
