在中国,用于心力衰竭患者的SGLT2抑制剂与保存的喷射分数:一个成本效益研究
He Lu1, Pingping Shang1, Dexing Zhou1
1The People's Hospital of Jiawang District of Xuzhou, Xuzhou, China.
Frontiers in pharmacology
|September 29, 2023
概括
对心力衰竭的empagliflozin和dapagliflozin干预措施具有保存的喷射分数 (HFpEF) 在中国具有成本效益. 这些治疗方法在支付意愿的门内提供了改善的质量调整寿命年 (QALYs).
科学领域:
- 心血管医学 心血管医学
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
背景情况:
- 来自EMPEROR-Preserved和DELIVER研究的实证证据突出显示了empagliflozin和dapagliflozin在心力衰竭中具有保存喷射分数 (HFpEF) 的好处.
- 这些SGLT2抑制剂干预HFpEF的成本效益仍需确定,特别是在特定的医疗保健系统内.
研究的目的:
- 在中国医疗保健的背景下,评估对HFpEF患者的empagliflozin和dapagliflozin干预措施的终身成本效益.
- 将增量成本效益比率 (ICER) 与国家支付意愿 (WTP) 门进行比较.
主要方法:
- 开发了一个20年马尔科夫模型,整合了具有里程碑意义的HFpEF试验的临床结果.
- 该模型预测了终身成本和经质量调整的寿命年 (QALYs),采用5%的折扣率.
- 进行了敏感性分析,以评估研究结果的可靠性.
主要成果:
- 对HFpEF的empagliflozin干预产生了每QALY3,691.56美元的ICER,低于中国12,032.10美元的WTP门.
- 对HFpEF的达帕格利弗洛辛干预导致每QALY的ICER为5,907.79美元,也低于WTP值.
- 心血管死亡率是决策中最敏感的因素;成本效益在67.9% (empagliflozin) 和62.2% (dapagliflozin) 的模拟中得到证实.
结论:
- 恩帕格利弗洛辛和达帕格利弗洛辛的干预措施代表了在中国管理HFpEF的成本有效策略.
- 该研究提供了对这些SGLT2抑制剂对HFpEF患者的长期经济价值的定量评估.
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