2型糖尿病SGLT2is经济价值的异质性:子组建模型成本效益分析
Kah Suan Chong1, Chun-Ting Yang1,2, Chi-Chuan Wang3,4,5
1Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701, Taiwan.
PharmacoEconomics
|September 12, 2025
概括
与二二酶4抑制剂 (DPP4is) 相比,-葡萄糖共运输体2抑制剂 (SGLT2is) 对2型糖尿病 (T2D) 管理具有非常高的成本效益. 这种成本效益在老年患者和轻度功能障碍患者中尤为明显.
科学领域:
- 药物经济学 药物经济学
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 已知SGLT2is的异质治疗效果,但它们在各种现实世界T2D种群中的经济价值尚不清楚.
- 小组成本效益分析对于了解不同患者个人资料中SGLT2i价值至关重要.
研究的目的:
- 评估SGLT2is与DPP4is在现实世界T2D患者中具有不同临床特征的成本效益.
- 确定SGLT2提供最大经济价值的患者子组.
主要方法:
- 采用多状态过渡模型来估计5年和终身时间的ICER和VBP.
- 根据年龄,eGFR,HbA1c和BMI对T2D患者进行了分层分析,使用台湾治疗效果,公用事业和成本的数据.
- 应用了3%的折扣率和2022年成本标准化,并进行了敏感性分析.
主要成果:
- 在5年内,ICER因子组而异,老年患者 (≥65岁) 和具有较高eGFR (60-90毫升/分钟/1.73米2) 的患者获得较低的QALY成本.
- 终身分析显示ICER总是较低,特别是在老年人 (≥65岁) 中.
- 基于价值的定价表明SGLT2is具有显著的经济价值,特别是在老年T2D患者中.
结论:
- 与DPP4is相比,SGLT2is在各种T2D患者亚组中表现出高的成本效益.
- 老年人和患有轻度功能障碍的患者是SGLT2i采用带来实质性经济利益的关键人群.
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