对埃索诺菲尔性食道炎当前治疗选择的成本效益分析
Brent Hiramoto1,2, Mayssan Muftah1,2, Ryan Flanagan1,2
1Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
The American journal of gastroenterology
|September 30, 2024
概括
从付款人的角度来看,六种食物消除饮食 (SFED) 是对乙性食道炎最具成本效益的初始治疗方法. 从社会角度来看,质子抑制剂 (PPI) 更具成本效益,特别是作为一线药理选择.
科学领域:
- 胃肠病学 胃肠病学
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
背景情况:
- 性食道炎 (EOE) 管理涉及多种策略,包括PPI,tCS,消除饮食和生物药物.
- 对于选择最初的EdE处理,存在有限的指导.
- 这些一线疗法的成本效益需要进行彻底的分析.
研究的目的:
- 为了比较埃索诺菲尔性食道炎的第一线治疗方法的成本效益.
- 从付款人和社会的角度评估PPI,tCS,SFED和dupilumab.
- 确定最佳的EoE初始治疗策略.
主要方法:
- 从付款人的角度开发了一个马尔科夫模型.
- 评估PPI,tCS和SFED作为初始疗法与治疗交叉.
- 包括社会视角分析和简化dupilumab比较.
主要成果:
- 从付款人的角度来看,SFED是5年来占主导地位的策略 (最有效,最便宜).
- 从社会角度来看,PPI是2年的最低成本选择,并且占据主导地位.
- 除非价格大幅降低,否则dupilumab不会具有成本效益.
结论:
- 对于付款人来说,SFED是最具成本效益的初始治疗;从社会角度来看,PPI是最受青的.
- PPI代表了对EoE最具成本效益的药理学第一线策略.
- 杜皮卢马布需要大幅降低价格才能成为可行的一线药物治疗.
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