新型口服抗凝药治疗非瓣膜病房颤的成本-效用分析  

Cost-utility Analysis of Novel Oral Anticoagulants in the Treatment of Non-valvular Atrial Fibrillation

作　　者：王声祥 任艳平 李楠 王倩 赵可新 Wang Shengxiang;Ren Yanping;Li Nan;Wang Qian;Zhao Kexin(Hebei PetroChina Central Hospital,Hebei Langfang 065000,China)

机构地区：[1]河北中石油中心医院,河北廊坊065000

出　　处：《中国药师》2020年第10期1971-1973,2029,共4页China Pharmacist

基　　金：2017年廊坊市科学技术研究与发展计划(编号:2017013052)。

摘　　要：目的:评价3种新型口服抗凝药物达比加群酯、阿哌沙班、利伐沙班治疗非瓣膜病房颤(NVAF)的成本-效用值,为合理用药及医保目录的评审、药品集中采购、价格谈判等提供决策依据。方法:构建Markov模型模拟NVAF发展过程,依据3种新型口服抗凝药物的国际多中心随机对照试验获得安全性和有效性数据,从文献中获取效用值,运行Treeage Pro 2011软件计算新型口服抗凝药物的成本-效用比,同时进行敏感性分析。结果:新型口服抗凝药治疗NVAF中达比加群酯110 mg成本-效用比18155.17,达比加群酯150 mg成本-效用比23034.72,阿哌沙班成本-效用比25979.16,利伐沙班成本-效用比18517.53。结论:达比加群酯110 mg在治疗NVAF过程中更具有经济优势,同时利伐沙班在治疗此类疾病相对于达比加群酯110 mg所增加的成本可以接受。Objective:To evaluate the cost-utility of dabigartan,apixaban and rivaroxaban in the treatment of non-valvular atrial fibrillation(NVAF)for the drug selection,appraisal of medical insurance,centralized procurement of drugs and price negotiation.Methods:Markov model was established to simulate the development of NVAF,the safety and effectiveness data were obtained based on the international multi-center randomized controlled trials,the utility values were obtained from literatures,the cost-utility value of new oral anticoagulants was calculated by using Treeage Pro 2011 software and the sensitivity analysis was conducted at the same time.Results:The new oral anticoagulant in the treatment of NVAF had a cost-utility ratio of 18155.17 for dabigartan 110 mg,23034.72 for dabigartan 150 mg,25979.16 for apixaban and 18517.53 for rivaroxaban.Conclusion:Dabigartan 110 mg has more economic advantages in the treatment of NVAF,and the additional cost of rivaroxaban compared with dabigartan 110 mg is acceptable.

关 键 词：非瓣膜病房颤 口服抗凝药 达比加群酯 阿哌沙班 利伐沙班 Markov模型 成本-效用分析 

分 类 号：F407.7[经济管理—产业经济]