利福昔明联合乳果糖治疗中国C型肝性脑病的药物经济学评价
Pharmacoeconomic evaluation of rifaximin combined with lactulose for the treatment of type C hepatic encephalopathy in China
阮锦凤 1石丰豪 2苏杭 1李薇 2韩晟2
作者信息
- 1. 北京大学医药管理国际研究中心,北京 100191
- 2. 北京大学医药管理国际研究中心,北京 100191;北京大学药学院,北京 100191
- 折叠
摘要
目的:对利福昔明联合乳果糖治疗C型肝性脑病进行药物经济学评价.方法:基于中国卫生体系角度,构建Markov模型模拟利福昔明片联合乳果糖口服溶液与单用乳果糖口服溶液治疗C型肝性脑病的长期健康产出与成本.临床疗效来源于已发表的临床随机对照实验结果,成本数据来源于已发表文献、专家调研及公开数据库,效用值来源于已发表的英国人群研究.采用单因素敏感性分析和概率敏感性分析验证结果稳健性.结果:基础分析结果显示,与单用乳果糖相比,利福昔明联合乳果糖治疗C型肝性脑病健康获益增加1.67个QALYs,治疗成本增加44 861.42元,ICER为26 832.28元/QALY,以中国2021年人均GDP(80976元)为支付阈值时,利福昔明联合乳果糖治疗肝性脑病是一项具有经济学优势的治疗方案.单因素敏感性分析及概率敏感性分析结果验证了模型及分析结果的稳健性.结论:与单用乳果糖相比,以2021年人均GDP(80 976元)为支付阈值时,利福昔明联合乳果糖治疗C型肝性脑病是具有经济性优势的治疗方案.
Abstract
OBJECTIVE To conduct the pharmacoeconomic evaluation of rifaximin combined with lactulose for the treat-ment of type C hepatic encephalopathy.METHODS A Markov model was constructed to simulate the long-term health out-comes and costs of rifaximin combined with lactulose versus lactulose for the treatment of type C hepatic encephalopathy based on the perspective of Chinese health system.Clinical efficacy was derived from published clinical randomize controlled trials,cost data from published literature,clinical experts research and publicly available databases,and utility values from published UK population studies.One-way sensitivity analysis and probabilistic sensitivity analysis(PSA)were used to verify the robustness of the results.RESULTS Base-case analysis results showed that compared with lactulose alone,rifaximin combined with lactulose increased health benefits by 1.67 QALYs and treatment costs by RMB 44 861.42 for patients with type C hepatic encephalopathy,with an incremental cost-effect ratio of RMB 26 832.28/QALY.When the per capita GDP in 2021(80 976 yuan)was used as the payment threshold,rifaximin combined with lactulose is a treatment scheme with economic advantage.One-way sensitivity analy-sis and probabilistic sensitivity analysis verified the robustness of the model and analysis results.CONCLUSION Rifaximin com-bined with lactulose is more cost-effective than lactulose alone for treating patients with type C hepatic encephalopathy.
关键词
利福昔明/乳果糖/C型肝性脑病/Markov模型/成本效用分析Key words
rifaximin/lactulose/type C hepatic encephalopathy/Markov model/cost-utility analysis引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据