西格列汀治疗2型糖尿病的药物经济学研究
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篇名: 西格列汀治疗2型糖尿病的药物经济学研究
TITLE:
摘要: 目的:考察西格列汀治疗2型糖尿病的健康效果、成本及成本-效果。方法:通过PubMed、Web of Scienic检索与筛选文献,选择不同的糖尿病治疗方案进行比较,包括西格列汀合并二甲双胍vs.格列美脲合并二甲双胍、西格列汀合并二甲双胍vs.阿卡波糖合并二甲双胍、西格列汀单药100 mg vs.阿卡波糖单药100 mg,tid。运用英国预测结局模型对不同治疗方案的长期治疗成本与长期治疗效果分别进行两两比较,并作出经济学评价。模型运行时间为40年,成本与效用的贴现率为3.0%。结果:与格列美脲合并二甲双胍、阿卡波糖合并二甲双胍比较,西格列汀合并二甲双胍方案延长的生命年(LYG)分别为0.03年和1.22年,每延长1个LYG所需的额外费用分别为44 055元和1 923元,低于世界卫生组织(WHO)建议的3倍人均国内生产总值(GDP)(125 724元);且分别延长了0.02个质量调整生命年(QALY)和0.95个QALY;每延长1个QALY所需的额外费用分别为58 717元和2 475元,低于WHO建议的3倍人均GDP(125 724元)。与阿卡波糖单药100 mg,tid比较,西格列汀单药100 mg/d方案处于绝对优势,延长了LYG(0.72年)和QALY(0.58年),且节约了费用(557元)。结论:按照WHO建议的3倍人均GDP为阈值(125 724元),西格列汀治疗2型糖尿病具有较好的成本-效果。
ABSTRACT: OBJECTIVE: To investigate health effect, cost and cost-effect of sitagliptin in the treatment of type 2 diabetes mellitus. METHODS: By retrieving PubMed, Web of Science, different diabetes mellitus therapy plans were selected and compared, including  sitagliptin combined with metformin vs. glimepiride combined with metformin, sitagliptin combined with metformin vs. acarbose combined with metformin, sitagliptin 100 mg vs. acarbose 100 mg,tid. UKPDS Outcomes Model was used to compare the long-term medical costs and outcomes among different therapy plans, and evaluated their economic effects. The model operated for 40 years, and both future costs and clinical benefits were discounted by 3.0%. RESULTS: Compared to the therapy of glimepiride or acarbose combined with metformin, the therapy of sitagliptin combined with metformin prolonged 0.03 and 1.22 years of life (LYG) per patient, and the additional costs were 44 055 yuan and 1 923 yuan for each year of life obtained, respectively, which were lower than 3-fold GDP (125 724 yuan) suggested by WHO; the add-on of sitagliptin provided a gain of 0.02 quality adjusted life year (QALY) and 0.95 QALY per patient, and the additional costs were 58 717 yuan and 2 475 yuan for each QALY respectively, which were lower than 3-fold GDP (125 724 yuan) suggested by WHO. Compared to acarbose monotherapy (100 mg, tid), the sitagliptin monotherapy (100 mg/d) was dominant, with longer LYGs (0.72 years) and QALYs (0.58 years) gained and lower cost (557 yuan saved). CONCLUSIONS: According to 3-fold GDP (125 724 yuan) recommended by WHO as threshold, sitagliptin demonstrate good cost-effectiveness in the treatment of type 2 diabetes mellitus.
期刊: 2016年第27卷第2期
作者: 祝菁菁,陈文
AUTHORS: ZHU Jingjing,CHEN Wen
关键字: 西格列汀;格列美脲;阿卡波糖;药物经济学;2型糖尿病;英国预测结局模型
KEYWORDS: Sitagliptin; Glimepiride; Acarbose; Pharmacoeconomics; Type 2 diabetes mellitus; UKPDS Outcomes Model
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