贝米肝素钠治疗骨科大手术后静脉血栓栓塞症的药物经济学评价
Pharmacoeconomic Evaluation of Bemiparin in Preventing Venous Thromboembolism after Major Orthopaedic Surgery
申斗 1徐鹏 2于淼 3付海天 3刘跃华 4杨燕绥1
作者信息
- 1. 清华大学医院管理研究院,北京 100084
- 2. 山东省立医院创伤骨科,济南 250021
- 3. 清华大学临床医学院,北京 100084
- 4. 清华大学万科公共卫生与健康学院,北京 100084
- 折叠
摘要
目的 评估贝米肝素钠预防骨科大手术后静脉血栓栓塞症(VTE)的成本-效果,以更好地做出临床用药决策.方法 构建决策树(预防阶段)和Markov模型(长期模拟),基于中国卫生体系视角评估贝米肝素钠与依诺肝素钠的成本-效果,研究时限为 15 年.转移概率数据主要来源于临床试验和文献,成本和效用数据主要来源于文献和调研.结果 基础分析结果显示贝米肝素钠具有绝对优势.模型预测贝米肝素钠组相比于比依诺肝素组,15 年内可额外增加 0.000 4 质量调整生命年(QALYs),且节省 2 179 元.概率敏感性分析显示,当意愿支付阈值为 85 698 元/QALY时,贝米肝素钠相比于依诺肝素钠具有成本-效果的概率为 98.8%.结论 在中国情境下,骨科大手术后采用贝米肝素钠预防 VTE具有成本-效果.
Abstract
Objective To evaluate the cost-effectiveness of bemiparin for the prevention of venous thromboembolism after major orthopaedic surgery,and to provide economic reference for clinical drug selection.Methods A model with a 15-year horizon was developed that included both prophylaxis period(represented as a decision tree)and long-term complications(represented as a Markov process).The analysis compared bemiparin vs enoxaparin from a National Healthcare Service.Transition probabilities were derived from clinical trials and published literature.Costs and utilities were derived from published literature and survey data.Results Bemiparin was shown to be dominant when compared with enoxaparin in the base-case analysis.The model predicted that bemiparin provided each patient an average benefit of 0.000 4 QALYs and saved 2 179 yuan in 15 years as compared with enoxaparin.Results of probabilistic sensitivity analysis indicated that 98.8%of patients believed bemiparin was of cost-effective advantage at willingness-to-pay thresholds(85 698 yuan/QALY).Conclusion It may be concluded that in the Chinese setting,belimumab was shown to be cost-effective for the prevention of VTE in Patients.
关键词
贝米肝素钠/骨科大手术/静脉血栓栓塞症/药物经济学评价Key words
Bemiparin/Major orthopaedic surgery/Venous thromboembolism/Pharmacoeconomic evaluation引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据