塞来昔布在中国治疗骨关节炎的成本效果研究
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篇名: 塞来昔布在中国治疗骨关节炎的成本效果研究
TITLE:
摘要: 目的:评估塞来昔布在中国治疗骨关节炎(OA)的成本效果。方法:采用英国国家卫生与临床优化研究所开发的一种OA成本-效果分析模型结构,对照药包括塞来昔布和双氯芬酸+质子泵抑制剂 (PPIs);不良事件的相对风险来自CONDOR试验。以质量调整生命年 (QALY) 计量有效性;每年以折现率4.76%折减成本和QALY。结果:塞来昔布的成本为$3 591,QALY为8.826年;双氯芬酸+PPIs的成本为$3 674,QALY为8.830年。塞来昔布相对于双氯芬酸+PPIs的增量成本和增量QALY分别为$-83和-0.004 QALY。双氯芬酸+PPIs相对于塞来昔布的增量成本效果比(ICER)为$ 23 258/QALY。单因素敏感度分析和概率敏感度分析结果显示,药物成本是ICER的主要驱动因素,且两种治疗方案的结果相似。结论:塞来昔布是一种成本低于双氯芬酸+PPIs的替代药物。两种用药方案之间的QALY差异非常小,因此塞来昔布可能是OA患者更具成本效果优势的选择。
ABSTRACT: OBJECTIVE: To evaluate cost-effectiveness of celecoxib for osteoarthritis (OA) in China. METHODS: OA cost-effectiveness analysis model developed by National Institute for Health and Clinical Excellence (NICE) was adopted using celecoxib, diclofenac+PPIs as control. Related risk of adverse event was from CONDOR trials.The effectiveness was measured by QALY. Costs and QALYs were discounted annually at 4.76%. RESULTS: Celecoxib had a cost of $3 591 and 8.826 QALYs while diclofenac+PPIs had a cost of $3 674 and 8.830 QALYs. The incremental costs and QALYs of celecoxib to diclofenac+PPIs were -$83 and -0.004 QALYs, respectively. The incremental cost-effectiveness ratio (ICER) for diclofenac+PPIs to celecoxib was $23 258/QALY. The results of single factor sensitivity analysis and probability sensitivity analysis showed that drug cost was driving factor of ICER, and the results of two therapy plans were similar.  CONCLUSIONS: Celecoxib is a less costly alternative than diclofenac+PPIs. The difference in QALYs between celecoxib and diclofenac+PPIs is extremely small, so celecoxib is likely to be cost-effective for OA patients.
期刊: 2017年第28卷第5期
作者: Bruce C.M. Wang,谢小平,Wesley Furnback,Ronald Caldwell
AUTHORS: Bruce C.M. Wang,XIE Xiaoping,Wesley Furnback,Ronald Caldwell
关键字: 骨关节炎;塞来昔布;双氯芬酸;质子泵抑制剂;成本效果;药物经济学
KEYWORDS: Osteoarthritis; Celecoxib; Diclofenac; PPI; Cost-effectiveness; Pharmacoeconomics
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