富马酸二甲酯治疗复发型多发性硬化的最小成本分析  

Cost-minimization analysis of dimethyl fumarate in the treatment of relapsing multiple sclerosis

作　　者：李伟[1] 孙轶竹 方佳 殷剑 LI Wei;SUN Yizhu;FANG Jia;YIN Jian(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing 211198,China;Tianjin Happy Life Technology Co.,Ltd.,Shanghai 200030,China;Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国药科大学国际医药商学院,南京211198 [2]天津开心生活科技有限公司,上海200030 [3]中国医学科学院老年医学研究院,北京100730

出　　处：《中国药房》2022年第24期3005-3009,共5页China Pharmacy

基　　金：中国药科大学“双一流”建设项目(No.CPU2018-GY41)。

摘　　要：目的评估富马酸二甲酯对比芬戈莫德治疗复发型多发性硬化(RMS)的经济性。方法从我国卫生体系角度出发,采用最小成本分析法评估富马酸二甲酯对比芬戈莫德治疗RMS的经济性。模型研究时限为2年,贴现率为5%。成本包括药品费用、治疗监测费用和不良反应处理费用,相关参数来自公开发表的文献、政府公开文件及专家访谈。对基础分析结果进行单因素敏感性分析,对模型研究时限进行情境分析。结果在已有的临床研究中,不同维度的间接Meta分析结果均显示,富马酸二甲酯和芬戈莫德在临床疗效上类似。在模型模拟的2年内,患者接受富马酸二甲酯治疗所花费的平均总成本为91756.3元,接受芬戈莫德的患者所花费的平均总成本为163761.5元,前者的医疗费用支出比后者平均减少了72005.2元。将研究时限延长至3年,接受富马酸二甲酯治疗的患者的医疗费用支出比接受芬戈莫德治疗的患者平均减少了105420.8元。对基础分析结果影响最大的因素为芬戈莫德的药品治疗费用。在敏感性分析的参数浮动范围内,增量成本均为负数,表明基础分析结果稳健。结论基于我国卫生体系角度,富马酸二甲酯治疗RMS比芬戈莫德更具经济性。OBJECTIVE To evaluate the cost-effectiveness of dimethyl fumarate versus fingolimod in the treatment of relapsing multiple sclerosis(RMS).METHODS The cost-effectiveness of dimethyl fumarate versus fingolimod in the treatment of RMS was evaluated with cost-minimization analysis from the perspective of China’s health system.The research period of the model was 2 years,and the discount rate was 5%.Costs included drug costs,treatment monitoring costs and adverse reaction disposal costs.Relevant parameters were from published literature,government documents and expert interviews.A one-way sensitivity analysis of the results and a scenario analysis of the model duration were performed.RESULTS In existing clinical studies,indirect meta-analysis results of different dimensions showed that dimethyl fumarate and fingolimod were similar in clinical efficacy.Within 2 years of the model simulation,total cost per patient using dimethyl fumarate was 91756.3 yuan and that of using fingolimod was 163761.5 yuan.The use of dimethyl fumarate was associated with savings of 72005.2 yuan compared with fingolimod.When extending study horizon to 3 years,the cost savings with the use of dimethyl fumarate increased to 105420.8 yuan,compared with fingolimod.The most influential factor on the results of the basic analysis was the drug treatment cost of fingolimod.Within the parameter fluctuation range of sensitivity analysis,the incremental costs were all negative,and the basic analysis results were robust.CONCLUSIONS Based on a health system perspective,dimethyl fumarate is more costeffective than fingolimod in the treatment of RMS.

关 键 词：富马酸二甲酯 芬戈莫德 复发型多发性硬化 最小成本分析法 

分 类 号：R956[医药卫生—药学]