西格列汀二甲双胍复合制剂治疗2型糖尿病的药物经济学评价  

Pharmacoeconomic evaluation of fixed-dose combination of sigliptin and metformin in the treatment of type 2 diabetes mellitus

作　　者：张明[1] 张荣迪 刘璐 刘畅 刘衍君 闫美兴 Zhang Ming;Zhang Rongdi;Liu Lu;Liu Chang;Liu Yanjun;Yan Meixing(Qingdao University,Qingdao 266000,China;Community Health Service Center on Luoyang Road of Shibei District,Qingdao 266000,China;Department of Pharmacy,Qingdao Women and Children's Hospital,Qingdao 266000,China;Community Health Service Center on Tongan Road of Shibei District,Qingdao 266000,China)

机构地区：[1]青岛大学,山东青岛266000 [2]青岛市市北区洛阳路街道社区卫生服务中心,山东青岛266000 [3]青岛市妇女儿童医院药学部,山东青岛266000 [4]青岛市市北区同安路街道社区卫生服务中心,山东青岛266000

出　　处：《实用药物与临床》2023年第12期1104-1109,共6页Practical Pharmacy and Clinical Remedies

基　　金：青岛市医疗卫生重点学科建设项目资助。

摘　　要：目的对西格列汀二甲双胍复合制剂(FDC)治疗2型糖尿病(T2DM)进行药物经济学评价。方法以一项西格列汀二甲双胍FDC随机临床对照研究(RCT)的数据为基础,采用Tree Age pro2011软件构建多状态的西格列汀二甲双胍FDC治疗T2DM的Markov模型,模拟在长期用药条件下西格列汀二甲双胍FDC治疗方案的经济性。以质量调整生命年(QALYs)为健康产出指标,以3倍的2021年国内生产总值(GDP)作为意愿支付阈值(WTP),用Markov模型模拟西格列汀二甲双胍FDC和单用二甲双胍治疗方案的长期效果与成本,并对相关参数进行敏感性分析,以检验结果的稳定性。结果以1年为1个循环周期,模拟30个周期后,西格列汀二甲双胍FDC组的增量成本-效用比(ICER)为82381.347元/QALYs,小于意愿支付阈值(ICER<WTP),具有成本效用优势。敏感性分析显示,模拟结果在参数变化范围内考察结果依然稳定。结论成本-效益分析显示,西格列汀二甲双胍FDC具有成本效益性,可延长患者的质量调整生命年。Objective To make economic evaluation of the fixed-dose combination(FDC)of sigliptin and metformin in the treatment of type 2 diabetes mellitus(T2DM).Methods Based on the data from a randomized clinical controlled trial(RCT)of FDC of sigliptin and metformin,a multi-state Markov model of the FDC treatment for T2DM was constructed by using Tree Age pro 2011 software,and the economics of the treatment regimen of the FDC under long-term medication conditions was simulated.Using quality adjusted life years(QALYs)as a health output indicator,and three-time 2021 gross domestic product(GDP)as a willingness threshold to pay(WTP),the Markov models were used to simulate the long-term effects and costs of the treatment regimen of FDC and those of metformin alone,and the sensitivity analysis was performed on relevant parameters to test the stability of the results.Results After simulating a one-year cycle for 30 cycles,the incremental cost-effectiveness ratio(ICER)of FDC group was 82381.347 yuan/QALYs,which was lower than the threshold of willingness to pay(ICER<WTP),and had an advantage of cost-effect.Sensitivity analysis showed the simulation results were still stable within the range of parameter changes.Conclusion Cost-effectiveness analysis shows the FDC of sigliptin and metformin is cost-effective and can extend the quality adjusted life years of patients.

关 键 词：西格列汀 二甲双胍 2型糖尿病 药物经济学 MARKOV模型 

分 类 号：R587.1[医药卫生—内分泌] R956[医药卫生—内科学]