吗替麦考酚酯两种制剂用于肾移植术后免疫抑制治疗的经济性评价
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篇名: 吗替麦考酚酯两种制剂用于肾移植术后免疫抑制治疗的经济性评价
TITLE: Economic Evaluation of Two Preparations of Mycophenolate Mofetil for Immunosuppressive Therapy after Renal Transplantation
摘要: 目的:评价吗替麦考酚酯(MMF)分散片对比MMF胶囊用于肾移植术后免疫抑制治疗的成本-效果,为临床选择更具有经济性的MMF制剂提供参考。方法:基于一项比较MMF分散片和MMF胶囊用于肾移植术后免疫抑制治疗的系统评价(共涉及6项临床研究),以6个月为模拟期限,应用Treeage2010软件建立决策树模型。模型设立移植物功能正常、急性排斥反应、移植物失功、死亡共4个状态,以质量调整生命年(QALYs)作为效果衡量指标,结合四川大学华西医院成本数据对MMF两种制剂进行成本-效果分析,并进行单因素敏感性分析和概率敏感性分析。结果:MMF胶囊组相对于MMF分散片组的增量成本-效果比为623111.6140元/QALY,高于我国意愿支付值(212676元/QALY);敏感性分析结果支持上述结果。结论:MMF分散片用于肾移植术后免疫抑制治疗的成本-效果优于MMF胶囊。
ABSTRACT: OBJECTIVE:To evaluate the cost-effectiveness between Mycophenolate mofetil (MMF)dispersible tablets versus MMF capsules for the immunosuppressive therapy after renal transplantation ,and to provide reference for selecting more economical MMF preparations. METHODS :Based on a systematic review about MMF dispersible tablets and MMF capsules for immunosuppressive therapy after renal transplantation (involving 6 clinical studies ),with simulation period of 6 months,Treeage 2010 software was used to establish decision tree model ,which included four states of graft normal ,acute rejection ,graft loss and death. Using QALYs as effect measurement index ,the cost-effectiveness analysis of two MMF preparations was carried out in combination with the cost data of West China Hospital of Sichuan University. Signal factor sensitivity analysis and probability sensitivity analysis were performed . RESULTS :The incremental cost-effectiveness ratio of MMF capsules group to MMF dispersible tablets group was 623 111.614 0 yuan/QALY,which was higher than Chinese willing-to-pay value (212 676 yuan/QALY);the results of sensitivity analysis supported the above results. CONCLUSIONS :MMF dispersible tablets are better than MMF capsules in cost-effectiveness of immunosuppressive therapy after renal transplantation.
期刊: 2020年第31卷第16期
作者: 杨甜,占美,戴冰,吴斌,徐珽
AUTHORS: YANG Tian,ZHAN Mei,DAI Bing,WU Bin,XU Ting
关键字: 吗替麦考酚酯;分散片;胶囊;肾移植;决策树模型;成本-效果分析
KEYWORDS: Mycophenolate mofetil ;Dispersible tablets ;Capsules;Renal transplantation ;Decision tree model ;Cost-effectiveness
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