司美格鲁肽和度拉糖肽的控制成本分析  

Control cost analysis of semaglutide versus dulaglutide

作　　者：谷卓琪 阮贞[2] 沈杨 GU Zhuo-qi;RUAN Zhen;SHEN Yang(Research Center of National Drug Policy&Ecosystem,China Pharmaceutical University,Jiangsu Nanjing 211198,China;Institute of Chinese Medical Sciences,University of Macao,Macao SAR 999078,China;School of Public Health,Peking University,Beijing 100083,China)

机构地区：[1]中国药科大学国家药物政策与医药产业经济研究中心,江苏南京211198 [2]澳门大学中华医药研究院,中国澳门999078 [3]北京大学公共卫生学院,北京100083

出　　处：《中国医院药学杂志》2023年第9期1002-1007,共6页Chinese Journal of Hospital Pharmacy

摘　　要：目的:采取中国卫生体系视角,计算40周治疗期间司美格鲁肽和度拉糖肽达到治疗目标的控制成本。方法:达到与血糖控制、体质量、低血糖结局相关的单一和复合终点的患者比例(数据)来自SUSTAIN7研究。成本测算包括药品费用、针头和不良反应成本。控制成本的计算方法是将每位患者使用每种药物的总成本,以2 022元人民币(CNY)表示,除以达到每个临床治疗终点的患者比例。结果:每周一次皮下注射0.5 mg司美格鲁肽(0.5 mg/周司美格鲁肽)在使患者达到治疗目标上更有效,且在各临床终点下显示出更低的控制成本。对于每名患者达到三联复合终点的成本,0.5 mg/周司美格鲁肽为7 321.3元,1.5 mg/周度拉糖肽为10 477.4元,1.5 mg/周度拉糖肽较司美格鲁肽高出43.1%。对于HbA1c≤6.5%、HbA1c<7%、HbA1c降低≥1.0%且体质量减轻≥3.0%、体质量减轻≥5%、体质量减轻≥10%而言,使用1.5 mg/周度拉糖肽相较使用0.5 mg/周司美格鲁肽的成本分别增加35.2%、31.6%、96.4%、90.2%和127.0%。结论:对于中国2型糖尿病患者的治疗而言,0.5 mg/周司美格鲁肽相较于1.5 mg/周度拉糖肽是更为经济的。OBJECTIVE To calculate the control cost of selmeaglutide and duraraneptide achieving treatment goals during the 40-week treatment period from the perspective of the Chinese health system.METHODS The proportions of patients achieving single and composite endpoints related to glycemic control,body weight,and hypoglycemia outcomes were taken from SUSTAIN 7 study.The cost included medication cost,needle cost and cost for adverse events.Cost of control was calculated as the cost per patient of each medication,expressed in 2022 RMB(CNY),and divided by the proportion of patients achieving each endpoint.RESULTS Once a week(OW)s.c.semaglutide 0.5mg was more effective in enabling patients to achieve therapeutic goals,and showed a lower cost of control at each modeled endpoints.For the cost of reaching the triple composite endpoint per patient,0.5 mg/week semaglutide was 7321.3 yuan,1.5 mg/week duraraneptide was 10477.4 yuan,and 1.5 mg/week duraraneptide was 43.1%higher than semaglutide.For each patient achieving an endpoint of HbA1c≤6.5%,HbA1c<7%and≥1.0%HbA1c reduction with≥3.0%,≥5%and≥10%weight loss,the cost of 1.5 mg/week duraraneptide increased by 35.2%,31.6%,96.4%,90.2%and 127.0%over 0.5 mg/week semaglutide,respectively.CONCLUSION For the treatment of Chinese patients with T2DM,OW s.c.semaglutide 0.5 mg is more economical than 1.5 mg/week dulaglutide.

关 键 词：成本分析 胰高血糖素样肽-1受体激动剂 2型糖尿病 司美格鲁肽 度拉糖肽 

分 类 号：R956[医药卫生—药学]