阿柏西普对比康柏西普治疗湿性年龄相关性黄斑变性药物经济学评价  

Pharmacoeconomic evaluation of aflibercept versus conbercept for the treatment of wet age-related macular degeneration

作　　者：刘丹 张伯超 张静[1] 王娟[1] 袁毅[1] 桂林 陈丽[1] LIU Dan;ZHANG Bochao;ZHANG Jing;WANG Juan;YUAN Yi;GUI Lin;CHEN Li(Department of Ophthalmology,Panzhihua Integrated Traditional Chinese and Western Medicine Hospital,Panzhihua 617000,Sichuan Province,China;Department of Cardiology,Changshou District Traditional Chinese Medicine Hospital in Chongqing,Chongqing 401220,China)

机构地区：[1]攀枝花市中西医结合医院眼科,四川攀枝花617000 [2]重庆市长寿区中医院心内科,重庆401220

出　　处：《中国药师》2024年第4期655-662,共8页China Pharmacist

基　　金：四川省中医药管理局科学技术研究专项课题(2021MS402)。

摘　　要：目的 对比阿柏西普与康柏西普治疗湿性年龄相关性黄斑变性的成本和效用,以期借助药物经济学的视角,为治疗方案的选择提供参考。方法 采用Markov模型,模拟在5年内两种治疗方案的生存状态,分别计算成本和健康产出,进行成本-效用分析获得增量成本效用比(ICUR)。采用单因素敏感性分析判断参数对ICUR的影响;采用概率敏感性分析判断各模型参数的不确定性对研究结果产生的影响。以1倍的2022年我国人均国内生产总值(GDP)为意愿支付阈值(WTP),判断其经济性。结果 在模拟期限内,与阿柏西普方案相比,康柏西普方案ICUR为-1 528 840元/质量调整生命年(QALY),低于WTP,具有明显的经济性。单因素敏感性分析显示,两种治疗方案轻度与中度视力状态之间的转移概率及每年注射阿柏西普次数是ICUR的重要影响因素。概率敏感性分析显示,在WTP为1倍GDP时,康柏西普具有显著的成本-效用优势(概率为65.9%),结果较为稳健。结论 对于治疗湿性年龄相关性黄斑变性,康柏西普相比与阿柏西普,具有成本-效用优势。Objective To compare the cost and utility of aflibercept and conbercept for the treatment of wet age-related macular degeneration(wetAMD),in order to provide a reference for the selection of treatment regimens from the perspective of pharmacoeconomics.Methods The incremental cost-utility ratio(ICUR)was obtained by using Markov model to simulate the survival of the two treatment regimens over the 5-year period,calculating costs and health outputs separately.Univariate sensitivity analysis was used to determine the impact of the parameter on ICUR,and probability sensitivity analysis was used to determine the influence of the uncertainty of each model parameter on the research results.One times the 2022 gross domestic product(GDP)per capita of China was used as the willingness-to-pay threshold(WTP)to judge its economy.Results Over the simulation period,the compazine regimen was significantly economical against the aflibercept regimen,with an ICUR of-1528840 per quality-adjusted life year(QALY),which was lower than the WTP.Univariate sensitivity analysis showed that the transition probability between mild and moderate visual status between the two regimens and the number of aflibercept injections per year were significant influencing factors of ICUR.Probabilistic sensitivity analysis pointed to a significant cost-utility advantage for conbercept at a WTP of one times GDP(probability of 65.9%),which was a more robust result.Conclusion For the treatment of wetAMD,conbercept has a cost-utility advantage compared with aflibercept.

关 键 词：湿性年龄相关性黄斑变性 阿柏西普 康柏西普 MARKOV模型 药物经济学分析 

分 类 号：R774.5[医药卫生—眼科] R956[医药卫生—临床医学]