环索奈德与布地奈德治疗轻中度支气管哮喘的成本-效用分析  

Cost-utility analysis of ciclesonide and budesonide in the treatment of mild to moderate bronchial asthma

作　　者：邹杰 黄洁莹 王丽娜 杜雯雯[1] 徐伟[1] ZOU Jie;HUANG Jieying;WANG Lina;DU Wenwen;XU Wei(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing 211198,China)

机构地区：[1]中国药科大学国际医药商学院,南京211198

出　　处：《中国药房》2025年第2期203-207,共5页China Pharmacy

基　　金：江苏省卫生健康发展研究中心开放课题(No.JSHD2022018)。

摘　　要：目的 评价环索奈德(CIC)与布地奈德(BUD)用于我国轻中度支气管哮喘患者维持治疗的经济性。方法 从中国卫生体系角度出发,以我国一项临床试验数据为基础并参考相关文献构建Markov模型,模型循环周期为1周,研究时限为60年,年贴现率为5%,以3倍2023年我国人均国内生产总值(GDP)为意愿支付(WTP)阈值,对CIC和BUD用药方案进行成本-效用分析,并进行单因素敏感性分析、概率敏感性分析及情境分析。结果 与BUD方案相比,CIC方案的增量成本为9 401.67元,患者可多获得0.001 3质量调整生命年(QALYs),增量成本-效果比(ICER)为6 928 868.26元/QALY,远超本研究设定的WTP阈值(268 074元/QALY)。单因素敏感性分析显示,CIC、BUD的用法用量及单价是对ICER影响较大的参数;概率敏感性分析证实,基础分析结果较为稳健;情境分析结果显示,当CIC价格降价至159.95元/瓶时,CIC方案具有经济性的概率与BUD方案相当。结论 以3倍我国人均GDP为WTP阈值,与BUD相比,CIC在当前价格下用于我国轻中度哮喘患者维持治疗不具有经济性。OBJECTIVE To evaluate the cost-utility of ciclesonide(CIC)versus budesonide(BUD)for the maintenance treatment of mild to moderate bronchial asthma.METHODS From the perspective of Chinese health service system,a Markov model was established based on the data from a clinical trial in China and some literature.The cycle length was 1 week,the time horizon was 60 years.A discount rate of 5%per year was applied.Cost-utility analysis was performed on therapeutic scheme of CIC and BUD using three times of China’s per capita gross domestic product(GDP)in 2023 as the threshold of willing-to-pay(WTP).One-way sensitivity analysis,probabilistic sensitivity analysis and scenario analysis were applied to test the uncertainty of basic analysis.RESULTS Compared with BUD scheme,the incremental cost of the CIC scheme was 9401.67 yuan,and the incremental quality-adjusted life years(QALYs)were 0.0013;incremental cost-effectiveness ratio(ICER)was 6928868.26 yuan/QALY,far beyond the threshold of WTP 268074 yuan/QALY.One-way sensitivity analysis showed that the usage,dosage and unit price of CIC and BUD were parameters that had a significant impact on ICER;probabilistic sensitivity analysis showed that the basic analysis results were relatively robust;scenario analysis showed that,when the price of CIC reduced to 159.95 yuan/branch,the probability of CIC scheme having economics was similar to that of BUD scheme.CONCLUSIONS At the current price,CIC is not economical compared with BUD for the maintenance treatment of mild to moderate asthma,using three times of China’s GDP in 2023 as the threshold of WTP.

关 键 词：环索奈德 布地奈德 支气管哮喘 维持治疗 成本-效用分析 

分 类 号：R956[医药卫生—药学] R977.1