对乌干达糖尿病基本药物潜在变化的经济评估
Atousa Bonyani1, Tracy K Lin2, Ambrose Jakira3
1Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America.
PloS one
|June 25, 2025
概括
乌干达可以通过优化其对2型糖尿病必需口服低血糖剂清单来节省数百万美元. 用更具成本效益的替代品取代某些药物可以提高负担能力和患者健康结果.
科学领域:
- 药物经济学和卫生政策
- 糖尿病管理 糖尿病管理
- 基本药物清单优化 基本药物清单优化
背景情况:
- 世界卫生组织建议根据可用性,可访问性,可负担性,成本效益,安全性和有效性来选择基本药物.
- 口服低血糖剂 (OHAs) 对于管理2型糖尿病至关重要.
- 乌干达基本药物和卫生用品清单 (EMHSLU) 指导药物采购和可用性.
研究的目的:
- 评估乌干达EMHSLU的OHAs的可用性,可访问性,可负担性,成本效益,安全性和有效性.
- 提出替代性OHA以提高成本节约和改善2型糖尿病患者的健康结果.
- 通过对OHAs的EMHSLU进行完善来评估政府潜在的储蓄.
主要方法:
- 进行了文献审查,以建立药物可用性,可访问性,可负担性,成本效益,安全性和疗效的指标.
- 进行了预算影响分析 (BIA),以评估改进EMHSLU.LU的潜在成本节约.
- 分析了乌干达五类可用的OHAs,在两个场景中评估政府的负担能力:EMHSLU内部的转变和非EMHSLU药物的使用.
主要成果:
- 添加到EMHSLU 2023的OHAs显示,与EMHSLU 2016相比,其可用性和可访问性较低.
- 预算影响分析表明,通过用glibenclamide取代glimepiride和gliclazide,政府每年可能节省高达265万美元的成本.
- 通过优化分别达帕格利弗洛辛和格利梅皮里德剂量,每年可节省高达23万美元和60万美元的额外费用;西塔格利普丁被确定为具有成本效益的OHA,ICER为6,132美元/QALY.
结论:
- 乌干达几种口服2型糖尿病药物的潜在替代品可以显著降低医疗保健成本.
- 为OHAs优化EMHSLU对于提高经济效率和患者健康结果至关重要.
- 证据支持西塔利普丁的成本效益,并建议战略性药物替代,以节省政府的大量资金.
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