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活性维生素Ｄ及其类似物治疗女性绝经后骨质疏松的经济性
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| 篇名： | 活性维生素Ｄ及其类似物治疗女性绝经后骨质疏松的经济性 |
| TITLE： | Cost-effectiveness of vitamin D analogue for postmenopausal osteoporosis in women |
| 摘要： | 目的 评估活性维生素Ｄ及其类似物治疗中国绝经后骨质疏松女性的经济性。方法从我国医疗卫生系统角度，采用Markov微观模拟模型，分析阿法骨化醇、骨化三醇和艾地骨化醇的临床及经济产出。模型所需的临床参数来源于网状Meta分析，成本和效用数据主要从文献中获取。模型循环周期为1年，研究时限为患者终身，意愿支付阈值为中国2023年人均国内生产总值的0.5倍（44679元/QALY）。通过单因素敏感性分析、概率敏感性分析和情境分析探讨模型结果的不确定性。结果艾地骨化醇的质量调整生命年（QALYs）为12.03QALYs，高于阿法骨化醇（11.94QALYs）和骨化三醇（11.92QALYs）；同时，艾地骨化醇的直接医疗成本为38805元，低于阿法骨化醇（45173元）和骨化三醇（45821元）。单因素敏感性分析结果显示，髋部骨折和椎骨骨折的风险比对结果的影响较大；概率敏感性分析与情境分析结果均显示基础分析结果稳健。结论对于中国绝经后骨质疏松女性的治疗，艾地骨化醇相比阿法骨化醇和骨化三醇更具经济性。 |
| ABSTRACT： | OBJECTIVE To evaluate the cost-effectiveness of vitamin D analogue for postmenopausal osteoporotic women in China. METHODS A Markov microsimulation model was developed to analyze the clinical and economic outcomes of eldecalcitol， alfacalcidol and calcitriol for postmenopausal osteoporosis from the healthcare system perspective in China. The clinical parameters required for the model were derived from network meta-analysis， while cost and utility data were primarily obtained from the literature. The cycle length was 1 year ， the time horizon was life time， and the willingness-to-pay threshold was 0.5 times the gross domestic product per capita in China in 2023（44 679 yuan/QALY）. Model uncertainty was tested with one-way sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis. RESULTS The quality-adjusted life years （QALYs） for eldecalcitol were calculated to be 12.03 QALYs， which were higher than those for alfacalcidol （11.94 QALYs） and calcitriol （11.92 QALYs）. Meanwhile， the direct medical cost associated with eldecalcitol treatment amounted to 38 805 yuan， which was lower than that of alfacalcidol （45 173 yuan） and calcitriol （45 821 yuan）. The results of the one-way sensitivity analysis showed that the risk ratio of hip fracture and vertebral fracture had a significant impact on the result. The probabilistic sensitivity analysis and scenario analysis showed the robustness of the findings from the base-case analysis. CONCLUSIONS Compared with alfacalcidol and calcitriol， eldecalcitol is likely to be a cost-effective treatment for postmenopausal osteoporotic women in China. |
| 期刊： | 2025年第36卷第10期 |
| 作者： | 官海静；徐雅楠；赵志刚；范长生 |
| AUTHORS： | GUAN Haijing，XU Yanan，ZHAO Zhigang，FAN Changsheng |
| 关键字： | 绝经后骨质疏松；活性维生素Ｄ及其类似物；阿法骨化醇；骨化三醇；艾地骨化醇；经济性 |
| KEYWORDS： | postmenopausal osteoporosis； vitamin D analogue； alfacalcidol； calcitriol； eldecalcitol； cost-effectiveness |
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