贝伐单克隆抗体与雷珠单克隆抗体治疗新生血管性年龄相关性黄斑变性的经济学评价  

Economic evaluation of bevacizumab versus ranibizumab in neovascular age-related macular degeneration

作　　者：李洪超[1] 黎晓新[2] 谢锋[3] 

机构地区：[1]中国药科大学国际医药商学院, 南京211198 [2] 北京大学人民医院眼科 [3] 加拿大汉密尔顿麦克马斯特大学临床流行病学与生物统计系

出　　处：《中华眼科杂志》2014年第6期426-433,共8页Chinese Journal of Ophthalmology

基　　金：国家十一五科技支撑计划课题（2006BAI02B05）

摘　　要：目的：评价在我国采用贝伐单克隆抗体（ bevacizumab ）与雷珠单克隆抗体（ ranibizumab ）治疗新生血管性AMD的经济性。方法成本效用分析。构建了一个Markov模型进行成本效用分析。根据视力定义了3个状态和1个死亡状态，模型周期为3个月，研究时限为10年。对多种因素进行了单因素敏感性分析和概率敏感性分析。结果在基础分析中，雷珠单克隆抗体组相对于贝伐单克隆抗体组患者平均多获得0.007质量调整生命年（ QALY ），但是平均成本增加了79.44万元，增量成本效用比（ ICUR）为10923万元/QALY。在所有敏感性分析中，雷珠单克隆抗体组与贝伐单克隆抗体组相比的ICUR均高于248万元/QALY，与基础分析结果一致。结论雷珠单克隆抗体与贝伐单克隆抗体治疗新生血管性AMD给患者带来的QALY相近，但成本更高，ICUR明显高于我国社会能够接受的QALY阈值。与雷珠单克隆抗体相比，贝伐单克隆抗体治疗新生血管性AMD更加经济。（中华眼科杂志，2014，50：426-433）Objective To evaluate the cost-effectiveness of bevacizumab versus ranibizumab for patients with neovascular age-related macular degeneration （ AMD） in China.Methods A Markov model was constructed to compare cost per quality-adjusted life year of bevacizumab with ranibizumab in patients with neovascular AMD.In the Markov model, with cycle length of 3 months and time horizon of 10 years, three health states were defined by visual acuity.One way deterministic and probabilistic sensitivity analyses were conducted to explore the uncertainties from a number of variables.Results In the base case analysis , patients in ranibizumab group obtained 0.007 QALY more than patients in bevacizumab group , while the average total cost was ￥794 400 higher.The ICUR reached ￥109.23 million per QALY.In all sensitivity analyses, the ICURs were over ￥ 2.48 million per QALY between ranibizumab and bevacizumab groups. Conclusions Ranibizumab for neovascular AMD patients gained similar QALY at significantly higher costs in comparison with bevacizumab.The ICURs generated in this study were much higher than the possible QALY threshold in the society of China.Compared with ranibizumab , bevacizumab was cost-effective for neovascular AMD patients.

关 键 词：新生血管性年龄相关性黄斑变性 经济学评价 抗血管内皮生长因子 贝伐单克隆抗体 雷珠单克隆抗体 

分 类 号：R774.5[医药卫生—眼科]