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罗格列酮钠和二甲双胍治疗2型糖尿病的药物经济学评价
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| 篇名： | 罗格列酮钠和二甲双胍治疗2型糖尿病的药物经济学评价 |
| TITLE： | Pharmacoeconomic Evaluation of Rosiglitazone Sodium and Metformin in the Treatment of Type 2 Diabetes Mell i- tus |
| 摘要： | 目的：为临床提供安全、有效、更具经济性的2型糖尿病用药方案建议。方法：构建罗格列酮钠和二甲双胍治疗2型糖尿病的Markov模型，根据2型糖尿病的病情发展特征，用2型糖尿病无并发症、2型糖尿病并发症、死亡等3个状态的动态变化来模拟该疾病的发展。对模型进行回乘分析、队列模拟分析以获取罗格列酮钠和二甲双胍治疗2型糖尿病的长期成本和效果；采用质量调整生命年（QALYs）作为健康产出指标，以糖尿病患者对糖尿病的意愿支付阈值（WTP）12000元/年判断不同方案的优劣性；对成本、效用和贴现进行敏感性分析，检验分析结果的稳定性。结果：Markov模型成本-效果分析结果显示，罗格列酮钠治疗方案累计成本和健康效用分别为25164.00元和7.50QALYs，二甲双胍治疗方案的累计成本和健康效用分别为17773.36元和7.36QA-LYs，罗格列酮钠相对于二甲双胍的增量成本效果比（ICER）为50983.08元/QALYs，大于WTP，因此二甲双胍治疗组为优势方案。敏感性分析显示，2型糖尿病的健康效用值和贴现率对模型的分析结果影响最大，但在本研究设定的敏感性分析范围内，优势方案结果并未改变。结论：对于2型糖尿病患者，在罗格列酮钠和二甲双胍两种方案中以二甲双胍更具成本-效果优势。 |
| ABSTRACT： | OBJECTIVE：To provid e reference for safe ，effective and economical medication scheme for type 2 diabetes mellitus（T2DM）. METHODS ：Markov model was established for rosiglitazone sodium and metformin in the treatment of T 2DM. According to the development characteristics of T 2DM，the development of T 2DM was simulated by the dynamic changes of event-free，complications and deaths of T 2DM. The long-term cost and effect of rosiglitazone sodium and metformin in the treatment of T 2DM were obtained by regression analysis and queue simulation analysis. QALYs was used as a health output indicator，and t he superiority and inferiority of different schemes were judged by the ICER value ，and in our study ICER value was WTP（12 000 yuan per year ）of diabetics. The sensitivity of cost ，utility and discount was analyzed to check the stability of the analysis results. RESULTS ：Cost-effectiveness analysis of Markov model showed that the cumulative cost and health effectiveness of rosiglitazone sodium therapy were 25 164.00 yuan and 7.50 QALYs，while 17 773.36 yuan and 7.36 QALYs for metformin ； ICER of rosiglitazone sodium relative to metformin was 50 983.08 yuan/QALYs，which was greater than WTP ，so the metformin treatment was an advantageous scheme. Sensitivity analysis showed that health utility value and discount rate of diabetes mellitus greatly influenced analysis results of the model ，but advantage plan had not changed within the sensiitivity analysis range seted in this study. CONCLUSIONS ：For T 2DM，metformin is more cost-effective than rosiglitazone sodium. |
| 期刊： | 2020年第31卷第02期 |
| 作者： | 席晓宇，谢雯雯，刘琰，黄蓉，陈磊 |
| AUTHORS： | XI Xiaoyu ，XIE Wenwen ，LIU Yan，HUANG Rong，CHEN Lei |
| 关键字： | 2型糖尿病；罗格列酮钠；二甲双胍；成本-效果；Markov模型；药物经济学 |
| KEYWORDS： | Type 2 diabetes mellit us；Rosiglitazone sodium ；Metformin；Cost-effectiveness；Markov model ；Pharmacoeconomic |
| 阅读数： | 399 次 |
| 本月下载数： | 14 次 |
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