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泛基因型直接抗病毒药物治疗慢性丙型肝炎的成本-效用分析
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| 篇名： | 泛基因型直接抗病毒药物治疗慢性丙型肝炎的成本-效用分析 |
| TITLE： | Cost-utility Analysis of the Pan-genotypic Direct-acting Antivirals in the Treatment of Chronic Hepatitis C Infection |
| 摘要： | 目的：评价泛基因型直接抗病毒药物（DAAs）治疗慢性丙型肝炎患者的成本-效用，为相关医疗卫生决策提供药物经济学证据。方法：从全社会角度出发，以中国初治慢性丙型肝炎患者为目标人群，参考文献资料建立Markov模型，以索磷布韦维帕他韦为对照，分析格卡瑞韦派伦他韦、索磷布韦+可洛派韦治疗慢性丙型肝炎患者的质量调整生命年（QALYs）和增量成本-效用比（ICERs）；采用敏感性分析验证结果的稳健性。结果：与索磷布韦维帕他韦相比，格卡瑞韦哌仑他韦增加了0.0021QALYs，成本增加25021元，ICERs为12129031元/QALY（意愿支付阈值为70892元/QALY），不具有成本-效用；当其单价下降至1679元时（降价64.65％）将具有成本-效用。索磷布韦+可洛派韦增加了0.0020QALYs，成本减少515元，是成本节约的绝对优势方案。敏感性分析显示，持续病毒学应答率和药品价格对结果的影响最大，索磷布韦+可洛派韦具有成本-效用的概率高于格卡瑞韦哌仑他韦。结论：格卡瑞韦哌仑他韦需大幅降低价格，才可达到更好的可负担性；索磷布韦+可洛派韦具有良好的经济性。 |
| ABSTRACT： | OBJECTIVE：To evaluate the cost-utility of the pan-genotypic direct-acting antivirals （DAAs）in the treatment of patients with chronic hepatitis C infection ，and to provide pharmacoeconomic evidence for relevant health care decisions. METHODS：A Markov model was established from a societal perspective with newly diagnosed chronic hepatitis C patients in China as the target population ，and analyzed quality-adjusted life years （QALYs）and incremental cost-utility ratios （ICERs）of patients with chronic hepatitis C with sofosbuvir/velpatasvir ，glecaprevir/pibrentasvir，sofosbuvir+coblopasvir. Sensitivity analysis was used to verity the robustness of the results. RESULTS ：Glecaprevir/pibrentasvir increased QALYs by 0.002 1 and costs by 25 021 RMB，compared to sofosbuvir/velpatasvir ；its ICERs was 12 129 031 yuan/QALY（willingness to pay threshold was 70 892 yuan/QALY），which had no cost-utility ；glecaprevir/pibrentasvir need to cut down the price by 64.65％ to have cost-utility. Sofosbuvir+coblopasvir increased QALYs by 0.002 0 and saved costs by 515 yuan，so it was the optimal regimen which was cost-saving. Sensitivity analysis showed that SVR rates and drug prices were the most influential factors. The probability of having cost-utility for sofosbuvir+coblopasvir was higher than glecaprevir/pibrentasvir. CONCLUSIONS ：Glecaprevir/pibrentasvir need to reduce the price to achieve better affordability. Sofosbuvir+coblopasvir shows economical advantage. |
| 期刊： | 2021年第32卷第08期 |
| 作者： | 魏霞，杨莉 |
| AUTHORS： | WEI Xia ，YANG Li |
| 关键字： | 慢性丙型肝炎；直接抗病毒药物；成本-效用分析；Markov模型；泛基因型 |
| KEYWORDS： | Chronic hepatitis C virus infection ；Direct-acting antivirals ；Cost-utility analysis ；Markov model ；Pan-genotypic |
| 阅读数： | 324 次 |
| 本月下载数： | 5 次 |
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