奥马珠单抗治疗重度过敏性哮喘的药物经济学评价
Pharmacoeconomic evaluation of omalizumab in the treatment of severe allergic asthma
熊朝刚 1朱玉蓉 2安梦娜 3李颖 1张鑫 1章圣洁 1冯柯臻 4封卫毅3
作者信息
- 1. 西安市胸科医院药剂科,西安 710100
- 2. 甘肃省妇幼保健院药学部,兰州 730050
- 3. 西安交通大学第一附属医院药学部,西安 710061
- 4. 陕西省第二人民医院临床药学部,西安 710005
- 折叠
摘要
目的 从我国医疗提供者角度出发,对奥马珠单抗治疗重度过敏性哮喘的经济性进行评价.方法 基于一项奥马珠单抗治疗重度过敏性哮喘的国际多中心研究数据,根据重度过敏性哮喘的疾病发展进程建立Markov模型,循环周期为4周,以质量调整生命年(QALYs)和增量成本-效果比(ICER)为产出指标,模拟奥马珠单抗联合标准治疗(SoC)方案对比SoC方案治疗重度过敏性哮喘的长期健康效果与成本,并采用单因素敏感性分析、概率敏感性分析和情境分析检验结果的稳健性.结果 与SoC方案相比,奥马珠单抗联合SoC方案的ICER为107723.05元/QALY,小于3倍2023年我国人均国内生产总值(GDP)的意愿支付(WTP)阈值(268074元/QALY).单因素敏感性分析结果显示,基线血清总免疫球蛋白E水平对模型的稳健性影响最大.概率敏感性分析结果显示,在阈值为268074元/QALY时,奥马珠单抗+SoC方案具有经济性的概率为93.00%.情境分析结果显示,真实世界中奥马珠单抗按药品规格而不按实际用量的计费方式可能会升高ICER.结论 以3倍2023年我国人均GDP为WTP阈值时,与SoC方案相比,奥马珠单抗联合SoC方案治疗重度过敏性哮喘具有经济性.
Abstract
OBJECTIVE To evaluate the cost-effectiveness of omalizumab in the treatment of severe allergic asthma from the perspective of healthcare providers in China.METHODS Based on the data from an international multicenter study of omalizumab in the treatment of severe allergic asthma,the Markov model was constructed according to the progression of severe allergic asthma,with a cycle of 4 weeks.Long-term health outcomes and costs of omalizumab combined with standard of care(SoC)regimen versus SoC regimen in the treatment of severe allergic asthma were simulated by using quality-adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICER)as output indexes.One-way sensitivity analysis,probabilistic sensitivity analysis,and scenario analysis were performed to test the robustness of the results.RESULTS Compared with the SoC regimen,ICER for the omalizumab combined with SoC regimen was 107723.05 yuan/QALY,which was less than the willingness-to-pay(WTP)threshold(268074 yuan/QALY)calculated by three times per capita gross domestic product(GDP)in China in 2023.The one-way sensitivity analysis showed that the baseline serum level of immunoglobulin E had the greatest impact on the robustness of the model.The probabilistic sensitivity analysis showed that the omalizumab+SoC regimen had a 93.00%probability of being cost-effective.The scenario analysis showed that in the real world,the billing method of omalizumab based on specifications rather than actual usage may increase ICER.CONCLUSIONS Compared with the SoC regimen,the combination of omalizumab and SoC regimen for treating severe allergic asthma is cost-effective,with a WTP threshold of three times China's per capita GDP in 2023.
关键词
奥马珠单抗/重度过敏性哮喘/成本-效用/Markov模型/药物经济学Key words
omalizumab/severe allergic asthma/cost-utility/Markov model/pharmacoeconomic引用本文复制引用
基金项目
国家自然科学基金(81972814)
教育部发展中心联合基金(2023HT053)
出版年
2024
国家科技期刊平台
NSTL
万方数据