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对于肥胖患者的十二指甲-关旁路袖装置的成本效益分析
Qian Xu1,2, Wei Yan1,2, Luo Li1,2
1Department of Health Economics, School of Public Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China.
Health economics review
|April 8, 2025
概括
结合强化生活方式干预 (ILI) 的十二指甲骨-关节绕道袖子 (DJBS) 在标准支付意愿门下,对中国的肥胖不具有成本效益. 然而,它在略高的门值时变得具有成本效益,表明潜在价值.
科学领域:
- 卫生经济学 卫生经济学
- 腹部外科 腹部外科
- 公共卫生 公共卫生
背景情况:
- 肥胖是一个重要的全球公共卫生挑战.
- 目前的干预措施包括改变生活方式,药物治疗和减肥手术.
- 这项研究评估了双胞胎 - 腹腔绕道袖子 (DJBS) 加上强化生活方式干预 (ILI) 与单独在中国的ILI的经济影响.
研究的目的:
- 进行对DJBS加上ILI的经济评估,与仅用于中国肥胖症治疗的ILI相比.
- 为了确定DJBS加ILI在9个月和终身时间的成本效益.
- 根据已确定的支付意愿 (WTP) 门来评估战略的价值.
主要方法:
- 混合决策树和马尔科夫模型被用于成本效益分析.
- 来自前性随机试验 (NCT05938231) 的临床疗效数据.
- WTP的门设定为中国2022年人均GDP和人均可支配收入的1-3倍. 进行了敏感性分析.
主要成果:
- 在9个月的时间里,DJBS + ILI将BMI降低了1.69公斤/平方米,额外成本为28,963.98日元,每个BMI单位下降的ICER为17,138.45日元.
- 在终身期内,DJBS + ILI导致成本增加 (13,261.94日元),寿命年 (0.02) 和QALY (0.15) 略有增长.
- 终身ICER为88412.93日元/获得的QALY;灵敏度分析证实了结果的稳定性.
结论:
- 当WTP处于人均GDP或可支配收入水平时,DJBS加ILI在中国的肥胖症上不具有成本效益.
- 当WTP门提高到人均GDP的1.03倍时,该战略变得具有成本效益.
- 经济评估表明,要仔细考虑WTP对低血压干预的门.
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