阿格列汀治疗2型糖尿病的药物经济学评价
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篇名: 阿格列汀治疗2型糖尿病的药物经济学评价
TITLE:
摘要: 目的:评价阿格列汀治疗2型糖尿病的经济性,为相关研究提供循证依据。方法:计算机检索Cochrane Library、Pubmed、EMBase、中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库等数据库中阿格列汀联用传统降糖药与单用传统降糖药比较治疗2型糖尿病的随机对照试验(RCT),检索时间为建库至2014年3月。基于文献二次分析思路,从文献中提取效果指标和疗程,从患者角度出发,以药物日均治疗费用计算成本,并采用成本-效果分析法,对阿格列汀联用传统降糖药方案与单用传统降糖药方案的经济性进行评价。结果与结论:共纳入符合标准的RCT文献6篇。当阿格列汀与二甲双胍联用疗程为12周时,以糖化血红蛋白(HbA1c)降低值作为效果指标考察,成本-效果较差;当疗程增加到26周时,以HbA1c达标率作为效果指标考察,成本-效果较差;但当阿格列汀价格降低10%或试验组效果取95%置信区间(CI)上限时,其成本-效果优于单用二甲双胍组。以HbA1c降低值作为效果指标考察,阿格列汀联用吡格列酮治疗12周的成本-效果较好,但当疗程增加到26周时,成本-效果较差;疗程增加到26周时,以HbA1c达标率为效果指标的敏感度分析结果显示,试验组效果指标取95%CI上限时,成本-效果优于单用吡格列酮组。阿格列汀联用伏格列波糖治疗12周时,以HbA1c降低值作为效果指标,成本-效果优于单用伏格列波糖组。建议今后应开展基于RCT的阿格列汀药物经济学研究,以及改善糖尿病患者长期生活质量的药物经济学研究。
ABSTRACT: OBJECTIVE: To evaluate the economical efficiency of alogliptin for type 2 diabetes and provide clinical evidence for related researches. METHODS: Retrieved from Cochrane Library, Pubmed, EMBase, CNKI, VIP, Wanfang, CBM database up from the start of the database to Mar., 2014, RCTs about alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen in the treatment of type 2 diabetes mellitus were included. Based on the secondary analysis method of literatures, Effectiveness indexes and treatment course were extracted from the literatures, from the perspective of patients, and daily treatment cost was used to calculate the cost; cost-effectiveness analysis was adopted to evaluate the economical efficiency of alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen. RESULTS and CONCLUSIONS: 6 literatures which met inclusion criteria were included. When alogliptin combined with metformin treatment lasted for 12 weeks, the decrease value of HbA1c as effect index showed poor cost-effectiveness; when treatment course increased to 26 weeks, the rate of qualified HbA1c as effect index showed poor cost-effectiveness. When the price of alogliptin decreased by 10% or the effects of trial group was the upper limit of 95%CI, the cost-effectiveness was superior to metformin regimen group. 12 weeks of alogliptin combined with pioglitazone treatment showed better cost-effectiveness than pioglitazone alone using the decrease value of HbA1c as effect; when treatment course increased to 26 weeks, the treatment showed poor cost-effectiveness; when treatment conrse increased to 26 weeks, using the rate of qualified HbA1c as effect indes, the results of sensitirity analysis showed that cost-effectiveness of trial group was better than that of pioglitazone alone group as the apper limit of 95% CI. When alogliptin combined voglibose treatment lasted for 12 weeks, the decrease value of HbA1c as effect index showed superior cost-effectiveness to voglibose regimen group. It is suggested to develop alogliptin pharmacoeconomics research based on RCTs and pharmacoeconomics research about improving diabetes patients’ long-term living quality.
期刊: 2016年第27卷第26期
作者: 王瑜,方煜,胡明
AUTHORS: WANG Yu,FANG Yu,HU Ming
关键字: 阿格列汀;2型糖尿病;成本-效果分析法;文献二次分析;药物经济学
KEYWORDS: Alogliptin; Type 2 diabetes; Cost-effectiveness analysis; Literature secondary analysis; Pharmacoeconomics
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