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基于净效益回归框架的胰岛素类似物与人胰岛素治疗2型糖尿病的成本-效果分析
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| 篇名： | 基于净效益回归框架的胰岛素类似物与人胰岛素治疗2型糖尿病的成本-效果分析 |
| TITLE： | Cost-effectiveness Analysis of Insulin Analogues and Human Insulin in the Treatment of Type 2 Diabetes Mellitus Based on Net-benefit Regression Framework |
| 摘要： | 目的：比较胰岛素类似物与人胰岛素治疗2型糖尿病的成本-效果，减轻患者疾病经济负担，同时为非随机化的药物经济学研究提供新思路。方法：采用重庆市某三级甲等医院的回顾性数据，共纳入533例2型糖尿病患者为研究对象，通过倾向性评分匹配平衡组间差异，构建净效益回归框架来分析胰岛素类似物与人胰岛素治疗2型糖尿病的成本-效果。结果：两种治疗方案的疗效与成本存在正向关系——胰岛素类似物的疗效优于人胰岛素，两者总有效率相差14.5％；相应的治疗成本也是胰岛素类似物高于人胰岛素，平均总成本相差960.3元。每增加1个单位临床效果（即总有效率），胰岛素类似物组患者需要比人胰岛素组多花费66.23元。净效益回归分析结果显示，患者选择治疗方案的支付意愿临界值为16947.5元。结论：当患者的最大支付意愿大于16947.5元时，适宜选择胰岛素类似物治疗方案；反之，则适宜选择人胰岛素治疗方案。倾向性评分技术应用于净效益回归分析可以为非随机化药物经济学拓宽可用数据的来源。 |
| ABSTRACT： | OBJECTIVE：To compare the cost-effectiveness of insulin analogues and human insulin in the treatment of type 2 diabetes mellitus ，to reduce economic burden of patients ，and to provide new ideas for non-randomized pharmacoeconomic research. METHODS ：Retrospective data of a Third-grade Class-A hospital were adopted and 533 patients with type 2 diabetes were taken as object to balance the difference between groups through propensity score matching ，and construct net-benefit regression framework so as to analyze the cost-effectiveness of insulin analogues and human insulin in the treatment of type 2 diabetes mellitus. RESULTS ：There was a positive relationship between the efficacy and cost of the two therapeutic schemes ，i.e. insulin analogues were more effective than human insulin ，and the difference of total effective rate between the two schemes was 14.5％. The corresponding treatment cost of insulin analogues was higher than that of human insulin ，and the average total cost difference was 960.3 yuan. The cost of insulin analogues was 66.23 yuan more than that of human insulin for each additional unit of clinical effect （total effective rate ）. Results of net-benefit regression analysis showed that critical value of willingness to pay of therapy plan was 16 947.5 yuan. CONCLUSIONS ：When the willingness to pay is more than 16 947.5 yuan，the insulin analogue scheme is suitable ；on the contrary ，the human insulin analogue scheme is suitable. The propensity scoring technology used for the net-benefit regression analysis can broaden the source of avaliable data for non-randomized pharmacoeconomic evaluation. |
| 期刊： | 2020年第31卷第23期 |
| 作者： | 邓丹，明鑫，尹锦，王怡，钱妍 |
| AUTHORS： | DENG Dan ，MING Xin ，YIN Jin ，WANG Yi ，QIAN Yan |
| 关键字： | 2型糖尿病；人胰岛素类似物；人胰岛素；倾向性评分匹配；净效益回归框架；成本-效果分析 |
| KEYWORDS： | Type 2 diabetes mellitus ；Insulin analogues ；Human insulin ；Propensity scoring matching ；Net-benefit regression |
| 阅读数： | 175 次 |
| 本月下载数： | 2 次 |
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