内镜,手术和药物肥胖疗法的成本效益:微观模拟和值分析
Monica Saumoy1, Devika Gandhi2, Seth Buller3
1Center for Digestive Health, Penn Medicine Princeton Medical Center, Plainsboro, New Jersey, USA.
Gut
|July 31, 2023
概括
内镜套胃形成术 (ESG) 和套胃切除术 (SG) 对于分别是I类和II/III类肥胖症具有成本效益. 塞马格卢提德需要大幅降低价格才能成为肥胖治疗的成本效益.
科学领域:
- 腹部外科 & 医疗减肥减肥
- 健康经济学与研究成果研究成果
- 肥胖医学 肥胖医学
背景情况:
- 肥胖是一种复杂的慢性疾病,需要有效和经济可行的治疗策略.
- 目前的干预措施包括生活方式干预 (LI),袖子胃切除术 (SG),内镜袖子胃整形术 (ESG) 和药物治疗,如semaglutide.
研究的目的:
- 为了比较SG,LI,ESG和semaglutide在治疗I,II和III类肥胖症方面的成本效益.
- 确定semaglutide的成本门,以实现成本效益.
主要方法:
- 一个半马科夫微模拟模型被用来评估40岁的肥胖患者的治疗策略.
- 进行了灵敏度和值分析,考虑了治疗费用和西马格卢提德的坚持.
- 增量成本效益比率 (ICER) 是根据100,000美元/QALY的支付意愿值计算的.
主要成果:
- 对于I类肥胖症,ESG是具有成本效益的 (4105美元/QALY),而对II类 (5883美元/QALY) 和III类 (7821美元/QALY) 肥胖症,SG是具有成本效益的.
- 在所有肥胖类别中,SG和ESG都比LI更具成本效益.
- 与LI (ICERs>350,000美元/QALY) 相比,塞马格卢提德的成本效益不佳,需要大幅降低价格才能保持竞争力.
结论:
- 对于I类和II/III类肥胖症,ESG和SG分别是具有成本效益的手术选择.
- 塞马格卢提德的成本效益取决于大幅降低价格,特别是为了与ESG和SG实现平价.
- 药物治疗如西马格卢提德,如果具有成本效益,可能会大幅减少与肥胖相关的死亡率,因为潜在的使用率更高.
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