达格列净联合二甲双胍治疗2型糖尿病的药物经济学系统评价
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篇名: 达格列净联合二甲双胍治疗2型糖尿病的药物经济学系统评价
TITLE:
摘要: 目的:系统评价达格列净联合二甲双胍治疗2型糖尿病的经济学特性。方法:计算机检索Health Technology Assessment(HTA)、Cochrane Library、PubMed、Embase、中国知网、万方数据知识服务平台、中国生物医学文献数据库等数据库建库至2017年7月公开发表的关于达格列净联合二甲双胍的药物经济学文献,英文检索词包括“sodium-glucose-transporter-2 inhibitors” “SGLT2 inhibitor”“metformin”“dapagliflozin”“cost”“benefit”“utility”“effectiveness”“pharmacoeconomic”“economic”,中文检索词包括“SGLT2抑制剂”“达格列净”“二甲双胍”“成本”“效益”“效用”“效果”“药物经济学”等,结局指标包括增量成本、增量效果、成本-效果比和增量成本-效果比(ICER)。系统评价纳入文献的经济学研究结果。结果:共纳入4篇有效研究,均为成本-效果分析。达格列净在英国、希腊、丹麦、芬兰、挪威和瑞典6个国家相比磺脲类降糖药经济性更高,ICER分别为€2 709/QALY、€10 494/QALY、€7 939/QALY、€5 433/QALY、€4 767/QALY和€6 094/QALY,均低于各国意愿支付阈值;达格列净在英国和希腊相比二肽基肽酶4(DDP-4)抑制剂经济性更高,ICER分别为€7 200/QALY和€15 120/QALY,均低于各国意愿支付阈值。结论:现有经济学研究显示,对于二甲双胍单药治疗血糖控制不佳的2型糖尿病患者,相比磺脲类降糖药和DDP-4抑制剂,达格列净联合二甲双胍的治疗方案更具经济性。
ABSTRACT: OBJECTIVE: To evaluate the pharmacoeconomic characteristics of dapagliflozin combined with metformin in the treatment of type 2 diabetes mellitus systematically. METHODS: Retrieved from Health Technology Assessment (HTA), Cochrane Library, PubMed, Embase, CNKI, Wanfang and CBM during database establishment to Jul. 2017, published pharmacoeconomics literatures about dapagliflozin combined with metformin were collected, using “sodium-glucose-transporter-2 inhibitors” “SGLT2 inhibitor” “metformin” “dapagliflozin” “cost” “benefit” “utility” “effectiveness” “pharmacoeconomic” “economic” as English retrieval words and “SGLT2 inhibitor” “dage liejing” “metformin” “cost” “benefit” “utility” “effectiveness” as Chinese retrieval words. Outcome indexes included incremental cost, incremental effect, cost-effectiveness ratio and incremental cost-effectiveness ratio (ICER). The results of the economic research in the included literatures were evaluated systematically. RESULTS: Totally of 4 literatures were included, and all of them were cost-effectiveness analysis. Dapagliflozin was  more cost-effective than sulfonylurea because the ICER of dapagliflozin were €2 709/QALY,€10 494/QALY,€7 939/QALY,€5 433/QALY,€4 767/QALY and €6 094/QALY in the UK, Greece, Denmark, Finland, Norway and Sweden, respectively, which were all lower than willingness-to-pay threshold. Dapagliflozin was more cost-effective than DPP-4 inhibitor, and the ICER were €7 200/QALY and €15 120/QALY in the UK and Greece, respectively, which were all lower than willingness-to-pay threshold. CONCLUSIONS: Current economic research shows compared with sulfonylurea and DDP-4 inhibitor, dapagliflozin is a cost-effective treatment alternative for patients with T2DM whose metformin regimen does not provide sufficient glycemic control.
期刊: 2018年第29卷第9期
作者: 黎风,何梅,邵鑫,刘福
AUTHORS: LI Feng,HE Mei,SHAO Xin, LIU Fu
关键字: 达格列净;二甲双胍;2型糖尿病;系统评价;药物经济学
KEYWORDS: Dapagliflozin; Metformin; Type 2 diabetes mellitus; Systematic review; Pharmacoeconomics
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