タイにおける慢性閉塞性肺疾患の単発吸入器トリプルセラピーの経済評価
Piyameth Dilokthornsakul1, Piyawat Dilokthornsakul2,3, Bunchai Chongmelaxme4
1Center for Medical and Health Technology Assessment (CM-HTA), Department of Pharmaceutical Care, Chiang Mai University, Chiang Mai, Thailand.
BMJ open respiratory research
|February 12, 2026
まとめ
単発吸入器トリプルセラピー (SITT) は,複数の吸入器トリプルセラピー (MITT) と比較して,現在タイでのCOPDの費用対効果は低い. フルチサゾンフロー酸/ユメクリドニウム/ヴィランテロル (FF/UMEC/VI) の30%の値下げにより,費用対効果の高いCOPD治療法となる可能性があります.
科学分野:
- 健康経済学 医療経済学
- 薬学経済学 薬学経済学
- 呼吸器医学とは
背景:
- 単発吸入器トリプルセラピー (SITT) は,西欧諸国におけるCOPDの費用対効果が高い.
- タイのような資源の限られた環境では,SITTの費用対効果に関する証拠は不足しています.
研究 の 目的:
- タイのCOPD患者に対する複数の吸入器トリプルセラピー (MITT) と比較してSITTの費用対効果を評価する.
- 資源が限られた医療制度において,SITTの経済的可行性を評価する.
主な方法:
- 社会的な観点から,生涯の地平線マルコフモデルが利用されました.
- 2つのSITT方式 (FF/UMEC/VIとBUD/GLY/FOR) とMITT (SAL/FP+TIO) を比較した.
- 品質調整寿命年数 (QALYs) とインクリメンタル費用対効果比率 (ICERs) を計算した.
主要な成果:
- FF/UMEC/VIはQALYのわずかな改善を示したが,高いICER (1,899,408THB/QALY) にあった.
- BUD/GLY/FORが優勢で,MITTよりも低いQALYと高いコストを提供した.
- FF/UMEC/VIは,THB160,000の値で費用対効果的になる確率は1.1%しかなかった.
結論:
- 現在のSITTの価格は,タイのCOPD治療にMITTと比較して費用対効果が低いことを意味します.
- フルチサゾンフローアート/ウメクリドニウム/ヴィランテロル (FF/UMEC/VI) は, ~30%の価格削減で費用対効果が高くなる可能性があります.
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