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德谷门冬双胰岛素治疗中国2型糖尿病患者的成本-效果分析
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| 篇名： | 德谷门冬双胰岛素治疗中国2型糖尿病患者的成本-效果分析 |
| TITLE： | Cost-effectiveness analysis of insulin degludec and insulin aspart in Chinese patients with type 2 diabetes mellitus |
| 摘要： | 目的 评估德谷门冬双胰岛素（IDegAsp）治疗中国2型糖尿病（T2DM）患者的长期经济性。方法采用成本-效果分析法，从中国卫生体系角度出发，使用CORE糖尿病模型对健康和经济结果进行长期（20年）模拟。基线队列特征及治疗效果数据来自CREATE研究，降糖药的价格分别参考医保支付标准和胰岛素专项集采接续平均中选价，日剂量来自CREATE研究，并发症成本和效用值来自已发表的文献，贴现率为5%。采用单因素敏感性分析、情境分析和概率敏感性分析验证结果的稳健性。结果既往使用基础胰岛素日制剂治疗的患者转换为IDegAsp治疗后可增加0.190质量调整生命年（QALY），并节约直接医疗成本42163.58元；既往使用预混胰岛素治疗的患者转换为IDegAsp治疗后可增加0.130QALY，并节约直接医疗成本41129.11元。贴现率和并发症成本对结果的影响较大；概率敏感性分析和情境分析验证了结果的稳健性。结论中国T2DM患者将基础胰岛素日制剂或预混胰岛素转换为IDegAsp治疗后，可改善患者的长期健康产出并节约成本，是更具经济性的治疗方案。 |
| ABSTRACT： | OBJECTIVE To evaluate the long-term cost-effectiveness of insulin degludec and insulin aspart （IDegAsp） in patients with type 2 diabetes mellitus （T2DM） in China. METHODS A cost-effectiveness analysis was conducted from the perspective of the Chinese healthcare system， using the CORE diabetes model to simulate long-term （20-year） health and economic outcomes. Baseline cohort characteristics and treatment effect data were derived from the CREATE study. The prices of glucose- lowering drugs were obtained from medical insurance payment standards and the average winning bid prices in the follow-up round of the specialized centralized procurement for insulin， while the daily dosages were derived from the CREATE study. The costs of complications and utility values were obtained from published literature， with a discount rate of 5%. One-way sensitivity analysis， scenario analysis， and probabilistic sensitivity analysis were performed to verify the robustness of the results. RESULTS Patients switching from previous once-daily basal insulin regimens to IDegAsp therapy gained an incremental 0.190 quality-adjusted life year （QALY） with direct medical cost savings of 42 163.58 yuan. For those switching from premixed insulin therapies， IDegAsp treatment provided 0.130 incremental QALY and reduced direct healthcare costs by 41 129.11 yuan. The outcome was significantly influenced by the discount rate and the cost of complications. Probabilistic sensitivity analysis and scenario analysis confirmed the robustness of these findings. CONCLUSIONS Switching from previous daily basal insulin or premixed insulin regimens to IDegAsp in Chinese patients with T2DM can improve patients’ long-term health outcomes and achieve cost savings， making it a more cost-effective treatment option. |
| 期刊： | 2025年第36卷第22期 |
| 作者： | 秦佳丽；张雅雯；张磊；江珊；游晓炎；王笑梅；王宪英 |
| AUTHORS： | QIN Jiali，ZHANG Yawen，ZHANG Lei，JIANG Shan，YOU Xiaoyan，WANG Xiaomei，WANG Xianying |
| 关键字： | 德谷门冬双胰岛素；基础胰岛素日制剂；预混胰岛素；成本-效果分析；2型糖尿病；真实世界数据 |
| KEYWORDS： | insulin degludec and insulin aspart； daily basal insulin； premixed insulin； cost-effectiveness analysis； type 2 |
| 阅读数： | 1 次 |
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