阿利西尤单抗联合他汀类药物治疗急性冠脉综合征的成本-效果分析  

Alirocumab with statin in the treatment of acute coronary syndrome:a cost-effectiveness analysis

作　　者：黄芸[1] 张心瞳 方崇波[1] 周华[1] 张宇宇[1] 马俐丽[1] HUANG Yun;ZHANG Xin-tong;FANG Chong-bo;ZHOU Hua;ZHANG Yu-yu;MA Li-li(Department of Pharmacy,Ningbo Medical Center of Lihuili Hospital,Zhejiang Ningbo 315100,China;Department of Pharmacy,Yidu Central Hospital of Weifang,Shandong Weifang 262500,China)

机构地区：[1]宁波市医疗中心李惠利医院药剂科,浙江宁波315100 [2]潍坊市益都中心医院药剂科,山东潍坊262500

出　　处：《临床药物治疗杂志》2022年第8期56-60,共5页Clinical Medication Journal

基　　金：浙江省自然科学基金(LY19H310007);浙江省药学会药物经济学与卫生技术评估专项(2022ZYJ12);浙江省药学会医院药学专项(2021ZYY41);宁波市医学重点学科建设项目(2022-F06)。

摘　　要：目的分析阿利西尤单抗联合他汀类药物治疗急性冠脉综合征(ACS)的成本-效果。方法从支付者角度,应用ODYSSEY OUTCOMES研究数据,结合目前我国ACS的医疗成本和心血管事件再发生概率等构建Markov模型,结果指标包括人均医疗成本、质量调整生命年(QALY)的健康指标和增量成本-效果比(ICER)。使用单因素敏感性分析和概率敏感性分析(PSA)探究模型潜在的不确定性。结果在为期20年的模拟治疗中阿利西尤单抗联合他汀类药物较他汀类单药治疗的人均医疗成本高,分别为239081和156403元,但联合用药效果更佳,QALY分别为9.6和9.4,ICER为413390元,大于预设的支付意愿阈值。结论与他汀单药相比,阿利西尤单抗联合他汀类药物治疗ACS可降低心血管事件的发生,但目前尚不具备成本-效果优势。Objective To evaluate the cost-effectiveness of long-term use of Alirocumab combined with statin in the treatment of patients with acute coronary syndrome(ACS).Methods ODYSSEY OUTCOMES research data was used in terms of the payer’s perspective.Markov mode was constructed on the base of current medical cost of patients with ACS combined with recurrence of cardiovascular events.The outcome indicators included per capita medical cost,the indicators of quality adjusted life year(QALY),and incremental cost-utility ratio(ICER).Single factor sensitivity analysis and probability sensitivity analysis(PSA)was used to explore the potential uncertainties of the model.Results The basic results showed that the per capita medical cost of alirocumab combined with statin was higher than that of statins alone,which was 239081 and 156403 yuan,respectively.However,the effect of combined treatment was better,with QALYs was 9.6 and 9.4,respectively.In the addition,the ICER was 413390 yuan,which was less than the preset threshold of willingness to pay.Conclusion In China,compared with statin monotherapy,the application of Alirocumab with statin in patients with ACS reduced the occurrence of cardiovascular events.But currently,it does not have the cost-effectiveness advantages.

关 键 词：阿利西尤单抗 急性冠脉综合征 成本-效果比 

分 类 号：R972.6[医药卫生—药品]