非奈利酮联合标准方案治疗糖尿病肾病的药物经济学评价  

Pharmacoeconomic evaluation of finerenone combined with standard treatment regimen in the treatment of diabetic nephropathy

作　　者：梁海[1] 夏茹楠 狄潘潘 赵蒙蒙 张鹏程 侯亚申 张红 吴炜[1] 杨淼[1] LIANG Hai;XIA Runan;DI Panpan;ZHAO Mengmeng;ZHANG Pengcheng;HOU Yashen;ZHANG Hong;WU Wei;YANG Miao(Dept.of Pharmacy,the People’s Hospital of Bozhou,Anhui Bozhou 236800,China)

机构地区：[1]亳州市人民医院药学部,安徽亳州236800

出　　处：《中国药房》2025年第1期86-90,共5页China Pharmacy

基　　金：安徽省重点研究与开发计划项目(No.2022e07020066);亳州市卫生健康科研项目(No.bzwj2023b001)。

摘　　要：目的对非奈利酮联合标准方案治疗糖尿病肾病(DN)的经济性进行评价。方法基于我国医疗服务提供者角度,在一项非奈利酮治疗DN的Ⅲ期临床试验基础上,建立非奈利酮联合标准治疗方案和标准治疗方案治疗DN的Markov模型,模拟周期为4个月,模拟时限为15年,年贴现率为5%,模拟非奈利酮联合标准治疗方案和标准治疗方案治疗DN患者终身的效果与成本;同时进行单因素敏感性分析、概率敏感性分析,以检验结果的稳健性。结果标准治疗方案的累计成本为579329.54元,累计效用为8.0524质量调整生命年(QALYs);非奈利酮联合标准治疗方案的累计成本为332520.61元,累计效用为8.1874 QALYs。非奈利酮联合标准治疗方案的成本更低且效果更好。单因素敏感性分析结果显示,透析、DN3及DN4状态的效用值对增量成本-效果比的影响较大,但未影响模型的稳健性。概率敏感性分析结果显示,非奈利酮联合标准治疗方案更具经济性的概率为100%。结论对于DN患者,使用非奈利酮联合标准治疗方案更具有经济性,为绝对优势方案。OBJECTIVE To evaluate the cost-effectiveness of finerenone combined with standard treatment regimen in the treatment of diabetic nephropathy(DN).METHODS From the perspective of healthcare service providers,a Markov model was established to simulate the dynamic changes of each stage in DN patients who received finerenone combined with the standard treatment regimen or the standard treatment regimen alone based on the phaseⅢclinical trial study of finerenone for DN.Markov model was used to perform the cost-effectiveness of long-term effects and the costs of the two therapies with a simulation cycle of 4 months,a simulation period of 15 years and an annual discount rate of 5%.At the same time,one-way sensitivity analysis and probability sensitivity analysis were performed,and the stability of the results was validated.RESULTS Accumulative cost of the standard treatment regimen was 579329.54 yuan,and the accumulative utility was 8.0524 quality-adjusted life year(QALYs);the accumulative cost of finerenone combined with the standard treatment regimen was 332520.61 yuan,and the accumulative utility was 8.1874 QALYs.Finerenone combined with the standard treatment regimen was more cost-effective.The results of one-way sensitivity analysis showed that dialysis status utility value,DN stage 3 utility value and DN stage 4 utility value had a great influence on the incremental cost-effectiveness ratio,but did not affect the robustness of the model.The results of probability sensitivity analysis showed that finerenone combined with the standard treatment regimen was more cost-effective with 100%probability.CONCLUSIONS For DN patients,finerenone combined with the standard treatment regimen is more cost-effective as an absolute advantage option.

关 键 词：非奈利酮 糖尿病肾病 成本-效用 MARKOV模型 药物经济学 

分 类 号：R956[医药卫生—药学]