对阿片类药物使用障碍患者使用延长释放布普伦诺芬的经济评估
Juliet M Flam-Ross1,2, Elizabeth Marsh1, Michelle Weitz1
1Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
JAMA network open
|September 13, 2023
概括
延长释放型布普伦诺芬在阿片类药物使用障碍的治疗中,与经布普伦诺芬相比,没有成本效益. 未来的努力应该集中在降低成本或改善注射形式的保留.
科学领域:
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
- 成 药物 药物 药物 药物
背景情况:
- 美国FDA于2017年批准延长释放布普伦诺芬用于阿片类药物使用障碍 (OUD).
- 虽然有效,但延长释放性布普伦诺芬的成本更高,保留率低于跨粘膜布普伦诺芬.
- 延长释放布普伦诺芬与跨粘膜布普伦诺芬的成本效益仍然不清楚.
研究的目的:
- 为了评估延长释放布普伦诺芬的成本效益与OUD治疗的跨粘膜布普伦诺芬相比.
主要方法:
- 一个状态过渡模型模拟了OUD患者的终身成本和质量调整寿命年 (QALYs).
- 数据来源包括临床试验,队列研究和行政数据.
- 模型参数分析时间为2021年9月至2023年1月.
主要成果:
- 与没有治疗相比,超粘膜布普伦诺芬的增量成本效益比 (ICER) 每QALY为19,740美元.
- 延长释放的布普伦诺芬效果较低 (0.03 QALYs低) 和成本比 transmucosal 布普伦诺芬更高,这表明它是主导的.
- 在60%的概率性敏感性分析中,超菌布诺芬是首选的策略.
结论:
- 延长释放性布普伦诺芬与OUD的跨粘膜布普伦诺芬相比,并不是一个具有成本效益的资源配置.
- 提高保留率或降低成本对于延长释放布伦诺芬的生存能力至关重要.
- 进一步的研究应该专注于优化OUD的治疗策略.
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