吡非尼酮与尼达尼布治疗特发性肺纤维化的成本-效果分析  

Cost-Effectiveness Analysis of Pirfenidone and Nintedanib in Idiopathic Pulmonary Fibrosis

作　　者：马艺蕾 伏振 段彦然 熊煌果 尹平[1] MA Yilei;FU Zhen;DUAN Yanran;XIONG Huangguo;YIN Ping(Department of Epidemiology and Biostatistics,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院公共卫生学院流行病与卫生统计学系,武汉430030

出　　处：《医药导报》2020年第11期1552-1557,共6页Herald of Medicine

基　　金：国家自然科学基金资助项目(81573262)。

摘　　要：目的对吡非尼酮与尼达尼布治疗特发性肺纤维化进行成本-效果分析,从患者角度比较二者经济效益,为临床药物选择提供参考。方法使用TreeAge Pro 2011版软件构建Markov模型,通过文献获得模型所需的效果参数与概率参数,依据国内药物定价及医院收费标准获得成本参数,对两种药物进行成本-效果分析,经比较得出结论。结果2年内,吡非尼酮组和尼达尼布组人均累积医疗费用人民币分别为142874.99元与439758.26元,人均累积用力肺活量占预计值百分比下降值分别为2.54与4.17,尼达尼布相比吡非尼酮每减少1例死亡所增加的成本为人民币12370136.40元,每减少一例急性加重所增加的成本为人民币4193266.58元。结论与尼达尼布组相比,在治疗特发性肺纤维化至2年时,吡非尼酮组肺功能下降更少而总医疗费用更低,因此吡非尼酮更具有经济学优势。Objective To access the cost effectiveness of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis and to compare the economic benefits of pirfenidone and nintedanib from the perspective of patients,so as to provide reference for clinical drug selection.Methods A Markov model was constructed using TreeAge Pro 2011 software.The effect parameters and probability parameters needed for the model were obtained through literature,and the cost parameters were obtained according to domestic drug pricing and hospital charging standards.A cost-effectiveness analysis of the two drugs was carried out and conclusions were drawn through comparison.Results In two years,the accumulated medical costs per patient in pirfenidone group and nintedanib group were 142874.99 yuan and 439758.26 yuan,respectively.The accumulated forced vital capacity percent predicted per patient decreased by 2.54 and 4.17 respectively in pirfenidone group and nintedanib group.Compared with nintedanib group,every reduction in deaths cost an additional 12370136.40 yuan and every reduction in serious adverse events cost an additional 4193266.58 yuan in pirfenidone group.Conclusion The patients in the pifenidone group have fewer pulmonary function deterioration and lower medical costs in the treatment of idiopathic pulmonary fibrosis for 2 years compared with the nintedanib group,so pifenidone has more economic advantages.

关 键 词：吡非尼酮 尼达尼布 特发性肺纤维化 MARKOV模型 成本-效果分析 

分 类 号：R974[医药卫生—药品] R956[医药卫生—药学]