基于决策树模型的磺酰脲类药物治疗2型糖尿病的药物经济学评价  

Pharmaco-Economic Evaluation of Sulfonylureas in the Treatment of Type 2 Diabetes Mellitus Based on the Decision Tree Model

作　　者：康乐 方琦 程君 李真真 张燕 胡蓉 KANG Le;FANG Qi;CHENG Jun;LI Zhenzhen;ZHANG Yan;HU Rong(Wusong Center Hospital of Baoshan District,Shanghai,China 200940)

机构地区：[1]上海市宝山区吴淞中心医院,上海200940

出　　处：《中国药业》2023年第S01期333-335,共3页China Pharmaceuticals

基　　金：上海市宝山区科学技术委员会科技创新专项资金项目[19-E-3];上海市宝山区卫生健康委员会优青(育才)计划项目。

摘　　要：目的为临床合理应用磺酰脲类降糖药物提供参考。方法采集医院门诊2019年6月至2020年5月首诊确诊且医嘱用药为格列吡嗪、格列齐特和格列美脲的2型糖尿病患者病历,记录降糖效果,构建决策树模型,进行成本-效果分析。采用龙卷风图行单因素敏感性分析,绘制成本-效果可接受曲线。结果格列吡嗪、格列齐特和格列美脲在降低患者空腹血糖、餐后2 h血糖和糖化血红蛋白水平方面的显效率分别为50%,67%,74%;决策树模型分析结果表明,格列吡嗪每0.47个效果的成本为90.45元,格列齐特每0.61个效果的成本为52.44元,格列美脲每0.67个效果的成本为136.66元。结论与格列吡嗪和格列美脲比较,格列齐特具有成本-效果优势。Objective To provide a reference for the rational application of sulfonylurea hypoglycemic drugs in clinical practice.Methods The medical records of patients diagnosed firstly with type 2 diabetes mellitus who were treated with glipizide,gliclazide and glimepiride at the outpatient clinic in the hospital from June 2019 to May 2020 were collected,and the effect of glucose lowering was recorded.A decision tree model was constructed to analyze the cost-effectiveness.A one-way sensitivity analysis was performed using a tornado diagram,and a cost-effectiveness acceptability curve was plotted.Results The effective rate of glipizide,gliclazide and glimepiride in reducing fasting blood glucose,2 h postprandial blood glucose and glycated hemoglobin levels in patients was 50%,67%,and 74%,respectively.The results of the decision tree model showed that the cost of glipizide was CNY 90.45 per 0.47 effects,the cost of gliclazide was CNY 52.44 per 0.61 effects,and the cost of glimepiride was CNY 136.66 per 0.67 effects.Conclusion Gliclazide has a cost-effectiveness advantage over glipizide and glimepiride.

关 键 词：磺酰脲类药物 2型糖尿病 成本-效果分析 格列吡嗪 格列美脲 格列齐特 

分 类 号：R956[医药卫生—药学]