甘精胰岛素100U/mL对比中效胰岛素(NPH)治疗中国2型糖尿病患者的成本效果分析  

Cost-effectiveness Analysis of Insulin Glargine 100U/mL Versus NPH Insulin in the Treatment of Type 2 Diabetes in China

作　　者：宣建伟 纪立伟[2] XUAN Jian-wei;JI Li-wei(Health Economics Research Institute,School of Pharmaceutical Sciences,Sun Yat-sen University,Guangzhou 510006,China;Department of Pharmacy,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)

机构地区：[1]中山大学药学院医药经济研究所,广州510006 [2]北京医院药学部国家老年医学中心,北京100730

出　　处：《药品评价》2019年第10期9-13,19,共6页Drug Evaluation

摘　　要：目的:评价甘精胰岛素100U/mL对比中效胰岛素(neutral protamine hagedorn,NPH)治疗接受口服降糖药(oral antidiabetic drugs,OADs)后血糖仍然控制不佳的中国2型糖尿病患者的长期成本效果。方法:运用CORE糖尿病模型,基于Lead临床研究治疗效果数据和已公开发表的中国糖尿病患者疾病成本数据,模拟计算中国2型糖尿病患者使用甘精胰岛素100U/mL或NPH胰岛素的质量调整生命年(quality-adjusted life year,QALY)和直接医疗成本,并进行成本效果分析。通过单因素和概率敏感性分析评估模型参数的不确定性对研究结果的影响。结果:与NPH胰岛素组相比,甘精胰岛素100U/mL组患者的人均期望寿命增加0.035年,质量调整生命年增加0.065QALY,直接医疗总成本减少603元,具有药物经济学优势。敏感度分析显示了研究结果的稳健型。结论:和NPH胰岛素相比,甘精胰岛素100U/mL能够提高接受OADs后血糖仍然控制不佳的中国2型糖尿病患者的QALY,并减少直接医疗成本,具有长期的药物经济学优势。Objective:To evaluate the long-term cost-effectiveness of Insulin Glargine 100U/mL vs.NPH insulin in the treatment of type 2 diabetes mellitus(T2DM)inadequately who were controlled by oral antidiabetic drugs(OADs)in China.Methods:The CORE Diabetes Model was used to estimate the life-time costs,quality-adjusted life year(QALY)gained,and cost-effectiveness of Insulin Glargine 100U/mL versus NPH Insulin based on LEAD clinical trial and published cost data in China.One-way and probabilistic sensitivity analyses were conducted to assess the underlying parameter uncertainty.Results:Compared with NPH insulin,Insulin Glargine 100U/mL was a dominant treatment option with a lifetime saving of CNY 603 in direct medical costs and an increased 0.065 QALYs gained per patient.Sensitivity analyses confirmed robustness of the results.Conclusion:Insulin Glargine 100U/mL is a cost-saving option with incremental effectiveness compared with NPH insulin for the treatment of type 2 diabetes inadequately controlled on OADs in China.

关 键 词：2型糖尿病 甘精胰岛素100U/mL NPH 成本效果分析 CORE糖尿病模型 

分 类 号：R587.1[医药卫生—内分泌]