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现在是中国优先考虑泛基因型疗法治疗型肝炎患者的时候了吗?
Yusi Tu1,2, Xiangyan Tang1,2, Dachuang Zhou1,2
1Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Cost effectiveness and resource allocation : C/E
|February 6, 2024
概括
全基因型C型肝炎治疗方案在中国具有成本效益,改善了患者的治疗结果. 然而,当基因型3b的流行率超过12%时,基因型鉴定至关重要,以确保最佳治疗.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 型肝炎的治疗已经发展到泛基因型治疗方案,但对3b基因型的有效性有限,这种基因型在中国普遍存在.
- 当前的指导方针建议,如果基因型3b的患病率超过5%,则应采用基因特异性治疗.
研究的目的:
- 评估中国C型肝炎泛基因型与基因特异性治疗方案的成本效益.
- 确定实施基因型识别的最佳基因型3b流行值.
主要方法:
- 一个决定马尔科夫模型从卫生系统的角度评估了有效性和成本效益.
- 模型参数来源于已发表的文献和公共数据库.
- 通过治愈的患者,不补偿性肝硬化,肝细胞癌,肝移植和质量调整寿命年 (QALYs) 来衡量有效性.
主要成果:
- 全基因型疗法产生了额外的0.13个QALY,增量成本为165美元 (ICER:1,268美元/QALY).
- 这些疗法每10万例患者中治愈的患者数量增加了5,868,显著减少了不补偿性肝硬化,肝细胞癌和肝移植需求.
- 对3b基因型患者的基因型鉴定在12%或更高的患病率下具有成本效益.
结论:
- 在中国,全基因型型肝炎治疗药物因其成本效益和疗效而被推.
- 在3b基因型患病率超过12%的地区,基因型鉴定和量身定制治疗是必要的.
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