伊班膦酸钠与唑来膦酸和因卡膦酸二钠治疗恶性肿瘤骨转移的成本-效用分析  

Cost-effectiveness Analysis of Ibandronate Sodium Versus Zoledronic Acid and Incardronate Disodium in the Treatment of Malignant Bone Metastases

作　　者：宋佳芳 朱贺 韩晟[1,2] SONG Jia-Fang;ZHU He;HAN Sheng(School of Pharmacy,Peking University,Beijing 100191,China;International Research Center for Pharmaceutical Administration,Peking University,Beijing 100191,China)

机构地区：[1]北京大学药学院,北京100191 [2]北京大学医药管理国际研究中心,北京100191

出　　处：《中国药物经济学》2019年第11期9-15,共7页China Journal of Pharmaceutical Economics

摘　　要：目的评价负荷剂量伊班膦酸钠与常规剂量唑来膦酸以及常规剂量因卡膦酸二钠治疗恶性肿瘤骨转移的成本-效用,为临床实践和政府决策提供证据参考。方法研究从健康保健体系角度出发,构建长期马尔可夫(Markov)决策分析模型,分别计算治疗所需成本和健康产出。通过增量成本-效用分析计算增量成本-效用比,使用中国3倍人均国内生产总值(GDP)作为支付意愿阈值,进行单因素敏感性分析和概率敏感性分析。结果基线研究结果显示,负荷剂量伊班膦酸钠组与常规剂量唑来膦酸组比较人均成本更高(90 243元比71 646元),与常规剂量因卡膦酸二钠组比较人均成本较低(90 243元比94 914元),产出更高(1.55 QALYs比1.24 QALYs,1.55 QALYs比1.36 QALYs),增量成本-效用比分别为61 130元/QALY和-24 281元/QALY。敏感性分析支持结果的稳健性。结论从健康保健体系角度看,基于长期的成本-效用分析结果,负荷剂量伊班膦酸钠治疗恶性肿瘤骨转移具有良好的经济学优势。Objective To evaluate the cost-effectiveness of loading dose of ibandronate with conventional doses of zoledronic acid and conventional doses of inkadronate for the treatment of malignant bone metastases, providing evidence for clinical practice and government decision-making. Methods From the perspective of health care system, the study constructed a long-term Markov decision analysis model to calculate the cost and health output of treatment. Incremental cost-utility analysis was used to calculate the incremental cost-utility ratio, using China’s three times per capita gross domestic product(GDP) as the willingness to pay threshold, to conduct single factor sensitivity analysis and probability sensitivity analysis. Results Baseline results showed that the loading dose of ibandronate group was higher than the conventional dose of zoledronic acid(90 243 yuan to 71 646 yuan), and the per capita cost was lower than the conventional dose of inkadronate group(90 243 yuan to 94914). The output is higher(1.55 QALYs than 1.24 QALYs, 1.55 QALYs to 1.36 QALYs), and the incremental cost-utility ratio is 61 130 yuan/QALY and-24 281 yuan/QALY, respectively. Sensitivity analysis supported the robustness of the results. Conclusion From the perspective of health care system, based on long-term cost-effectiveness analysis, loading dose of ibandronate sodium has good economic advantages in the treatment of bone metastases from malignant tumors.

关 键 词：伊班膦酸钠 恶性肿瘤 骨转移 成本-效用分析 

分 类 号：R730.6[医药卫生—肿瘤] R956[医药卫生—临床医学]