针对儿科发病的埃索诺菲尔性食道炎的连续疗法的成本效益分析
José Vicente Arcos-Machancoses1,2,3, Elena Crehuá-Gaudiza1,2,3, Cecilia Martínez-Costa1,2,3
1Department of Paediatric Gastroenterology, Hepatology and Nutrition, Hospital Clínic Universitari, Valencia, Spain.
Journal of pediatric gastroenterology and nutrition
|June 9, 2025
概括
对于儿科异性食道炎 (EOE) 的最具成本效益的治疗方法包括质子抑制剂 (PPI),牛奶消除饮食 (CM-ED) 和布德索尼德口腔可分散片 (BOT). 这个序列平衡了效率和成本,为管理EoE提供了一个可行的选择.
科学领域:
- 胃肠病学 胃肠病学
- 药物经济学 药物经济学
- 儿科健康 儿科健康
背景情况:
- 性食道炎 (EoE) 是一种慢性免疫介导的食道疾病.
- 儿科EoE的第一线治疗包括局部皮质类固醇,质子抑制剂 (PPI) 和消除饮食 (ED).
- 杜比卢马布 (DUP) 通常只用于耐火病例.
研究的目的:
- 为了评估儿科异性食道炎 (EOE) 的各种顺序治疗策略的成本效益.
- 确定在经济上最有效的治疗途径来管理儿童的EOE.
主要方法:
- 从付款人的角度来看,一个10年马尔科夫模型模拟了EoE的顺序性处理序列.
- 包括饮食选择 (从两种食物或母牛奶 (CM) 提升ED),局部皮质类固醇 (粘性溶液或布德胺口腔可分散片 (BOT)),以及Dupilumab (DUP).
- 使用增量成本效益比率 (ICUR) 评估成本效益,与30,000欧元的支付意愿 (WTP) 门相比.
主要成果:
- 序列PPI-ED(CM) -BOT-DUP是最具成本效益的 (€2373/QALY,7.20 QALY). 这是一个很好的选择.
- 杜皮卢马布-BOT-PPI-ED ((CM) 产生的QALY最高 (7.42),但成本效益不高 (中位数ICUR为323,774欧元/QALY).
- PPI-BOT-ED(CM) -DUP显示,WTP的可能性很高 (83%),其中位数ICUR为25,156欧元/QALY和7.31QALY.
结论:
- 布德塞尼德口溶性片 (BOT) 和牛奶 (CM) 开始的逐步消除饮食 (ED) 是有效和成本效益的EoE治疗序列的关键组成部分.
- 该PPI-BOT-ED(CM) -DUP序列提供了高效率和成本效益之间的平衡,用于儿科EdE管理.
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