Pharmacoeconomics of ivabradine in the treatment of CHF in the context of “Quadruple Therapy”

CHEN Congling; WU Han; ZHOU Jie; ZHANG Ruobin; ZHANG Jinping; BAO Xue; YANG Xian

doi:10.6039/j.issn.1001-0408.2024.01.11

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Pharmacoeconomics of ivabradine in the treatment of CHF in the context of “Quadruple Therapy”

更新时间：2024-01-11

- Pharmacoeconomics of ivabradine in the treatment of CHF in the context of “Quadruple Therapy”
- ZHONGGUO YAOFANG Vol. 35, Issue 1, Pages: 63-68(2024)
- 作者机构：
  
  1.南京鼓楼医院药学部，南京　210008
  2.中国药科大学基础医学与临床药学学院，南京　211198
  3.南京鼓楼医院心脏科，南京　210008
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2024.01.11
  CLC： R956;R972
- Published：15 January 2024，
  
  Received：11 September 2023，
  
  Revised：14 December 2023，
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陈琮玲,吴韩,周洁等.“新四联”背景下伊伐布雷定治疗CHF的药物经济学评价 ^Δ[J].中国药房,2024,35(01):63-68.

CHEN Congling,WU Han,ZHOU Jie,et al.Pharmacoeconomics of ivabradine in the treatment of CHF in the context of “Quadruple Therapy”[J].ZHONGGUO YAOFANG,2024,35(01):63-68.
陈琮玲,吴韩,周洁等.“新四联”背景下伊伐布雷定治疗CHF的药物经济学评价 ^Δ[J].中国药房,2024,35(01):63-68. DOI： 10.6039/j.issn.1001-0408.2024.01.11.

CHEN Congling,WU Han,ZHOU Jie,et al.Pharmacoeconomics of ivabradine in the treatment of CHF in the context of “Quadruple Therapy”[J].ZHONGGUO YAOFANG,2024,35(01):63-68. DOI： 10.6039/j.issn.1001-0408.2024.01.11.

摘要

目的

从卫生体系角度出发，评价伊伐布雷定在“新四联”背景下治疗慢性心力衰竭（CHF）的经济性。

方法

基于真实世界队列研究数据，根据CHF疾病自然发展进程构建Markov模型，循环周期设为3个月，研究时限为20年，贴现率为5%；以质量调整生命年（QALY）和增量成本-效果比（ICER）为产出指标，采用成本-效用分析法评价伊伐布雷定联合“新四联”方案相较于“新四联”方案治疗CHF的经济性，并通过单因素敏感性分析、概率敏感性分析验证基础分析结果的稳健性。

结果

基础分析结果显示，伊伐布雷定联合“新四联”方案相较于“新四联”方案的ICER为165 065.54元/QALY，低于以3倍我国2022年人均国内生产总值（GDP）作为的意愿支付（WTP）阈值（257 094元/QALY）。单因素敏感性分析结果显示，贴现率对模型的稳健性影响最大。概率敏感性分析结果显示，在本研究的WTP阈值下，伊伐布雷定联合“新四联”方案具有经济性的概率为59.50%。

结论

当采用3倍我国2022年人均GDP（257 094元/QALY）作为WTP阈值时，伊伐布雷定联合“新四联”方案治疗CHF具有经济性。

Abstract

OBJECTIVE

To evaluate the cost-effectiveness of ivabradine in the treatment of chronic heart failure （CHF） in the context of “Quadruple Therapy” from the perspective of the health system.

METHODS

Based on real-world cohort data， the Markov model was constructed according to the natural progression of CHF， with a cycle time of 3 months， a study timeframe of 20 years， and a discount rate of 5%. Using quality-adjusted life year （QALY） and incremental cost-effectiveness ratios （ICER） as the output indexes， the cost-utility analysis was used to evaluate the cost-effectiveness of ivabradine in combination with the “Quadruple Therapy” regimen， compared with the “Quadruple Therapy” regimen for the treatment of CHF， and the robustness of the results of the base analysis was verified by univariate sensitivity analysis and probabilistic sensitivity analysis.

RESULTS

The results of the base analysis showed that the ICER of ivabradine combined with the “Quadruple Therapy” regimen was 165 065.54 yuan/QALY， compared with the “Quadruple Therapy” regimen， which was lower than the willingness-to-pay （WTP） threshold （257 094 yuan/QALY） based on 3 times of China’s gross domestic product （GDP） per capita in 2022. The results of the univariate sensitivity analysis showed that the discount rate had the greatest impact on the robustness of the model. The probabilistic sensitivity analysis showed that the probability that the ivabradine combined with the “Quadruple Therapy” regimen was cost-effective under the WTP threshold in this study was 59.50%.

CONCLUSIONS

When using 3 times China’s 2022 GDP per capita （257 094 yuan/QALY） as the WTP threshold， the combination of ivabradine and the “Quadruple Therapy” regimen for treating CHF is cost-effective.

关键词

慢性心力衰竭伊伐布雷定新四联Markov模型药物经济学

Keywords

ivabradineQuadruple TherapyMarkov modelpharmacoeconomics

references

ZANNAD F，FERREIRA J P，POCOCK S J，et al. SGLT2 inhibitors in patients with heart failure with reduced ejection fraction：a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials[J]. Lancet，2020，396（10254）：819-829.

MCDONAGH T A，METRA M，ADAMO M，et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Eur Heart J，2021，42（36）：3599-3726.

中华医学会老年医学分会心血管疾病学组，《老年慢性心力衰竭诊治中国专家共识》编写组. 老年人慢性心力衰竭诊治中国专家共识：2021[J]. 中华老年医学杂志，2021，40（5）：550-561.

The Cardiovascular Disease Group of the Geriatrics Branch of the Chinese Medical Association，the Writing Group of the Chinese Expert Consensus on the Diagnosis and Treatment of Chronic Heart Failure in the Elderly. Chinese experts consensus on the diagnosis and treatment of chronic heart failure in the elderly：2021[J]. Chin J Geriatr，2021，40（5）：550-561.

AGBOR V N，CHEN Y P，CLARKE R，et al. Resting heart rate and risk of left and right heart failure in 0.5 million Chinese adults[J]. Open Heart，2022，9（1）：e001963.

SWEDBERG K，KOMAJDA M，BÖHM M，et al. Ivabradine and outcomes in chronic heart failure （SHIFT）：a randomised placebo-controlled study[J]. Lancet，2010，376（9744）：875-885.

葛均波，霍勇，杨杰孚，等. 慢性心力衰竭“新四联”药物治疗临床决策路径专家共识[J]. 中国循环杂志，2022，37（8）：769-781.

GE J B，HUO Y，YANG J F，et al. Expert consensus on clinical decision：making pathway for “new quadruple combination” pharmacotherapy management of chronic heart failure[J]. Chin Circ J，2022，37（8）：769-781.

国家药品监督管理局药品审评中心. 国家药监局关于发布真实世界证据支持药物研发与审评的指导原则（试行）的通告：2020年第1号[EB/OL]. （2020-01-07）[2023-05-03]. https：//www.nmpa.gov.cn/xxgk/ggtg/ypggtg/ypqtggtg/20200107151901190.htmlhttps://www.nmpa.gov.cn/xxgk/ggtg/ypggtg/ypqtggtg/20200107151901190.html.

The Drug Evaluation Center of the National Medical Pro- ducts Administration. Notice of the National Medical Products Administration on the guiding principles for releasing real world evidence to support drug research and evaluation （trial）：No. 1 of 2020[EB/OL].（2020-01-07）[2023-05-03]. https：//www.nmpa.gov.cn/xxgk/ggtg/ypggtg/ypqtggtg/20200107151901190.htmlhttps://www.nmpa.gov.cn/xxgk/ggtg/ypggtg/ypqtggtg/20200107151901190.html.

中华医学会心血管病学分会心力衰竭学组，中国医师协会心力衰竭专业委员会，中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志，2018，46（10）：760-789.

Heart Failure Group of the Cardiovascular Branch of the Chinese Medical Association，Heart Failure Professional Committee of the Chinese Medical Association，Editorial Committee of the Chinese Journal of Cardiovascular Di- sease. China guidelines for diagnosis and treatment of heart failure 2018[J]. Chin J Cardiol，2018，46（10）：760-789.

国家卫生健康委员会. 中国卫生健康统计年鉴：2022[M]. 北京：中国协和医科大学出版社，2022：117.

National Health Commission. China health statistics yearbook：2022[M]. Beijing：China Union Medical College Press，2022：117.

HONG S H，LEE J Y，PARK S K，et al. The utility of 5 hypothetical health states in heart failure using time trade-off （TTO） and EQ-5D-5L in Korea[J]. Clin Drug Investig，2018，38（8）：727-736.

刘国恩.中国药物经济学评价指南2020[M].北京：中国市场出版社，2020：28，46.

LIU G E. Guidelines for evaluation of Chinese pharmacoeconomics 2020[M]. Beijing：China Market Press，2020：28，46.

熊梦雪. 基于Markov模型的三种抗血小板药物的经济学评价[D].唐山：华北理工大学，2022.

XIONG M X. A Markov pattern analysis about three kinds of dual antiplatelet therapy[D]. Tangshan：North China University of Science and Technology，2021.

中国疾病预防控制中心慢性非传染性疾病预防控制中心，国家卫生健康委统计信息中心. 中国死因监测数据集2021[M]. 北京：中国科学技术出版社，2021：13-14.

The Chronic Non-Communicable Disease Prevention and Control Center of the China Center for Disease Control and Prevention，the Statistical Information Center of the National Health Commission. Chinese cause of death monitoring dataset 2021[M]. Beijing：China Science and Technology Press，2021：13-14.

周颖玉，吴群红. 经济学理论视角下的健康贴现率研究[J]. 中国卫生经济，2023，42（1）：1-3.

ZHOU Y Y，WU Q H. Further discussion on health discount rate from the perspective of economic theory[J]. Chin Health Econ，2023，42（1）：1-3.

中国心血管健康与疾病报告编写组.中国心血管健康与疾病报告2020概要[J].中国循环杂志，2021，36（6）：521-545.

The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases burden in China：an updated summary of 2020[J]. Chin Circ J，2021，36（6）：521-545.

HU D Y，HUANG D J，YUAN Z Y，et al. Efficacy and safety analysis of ivabradine hydrochloride treatment of Chinese patients with chronic heart failure：subgroup analysis of Chinese patients in the SHIFT study[J]. Zhonghua Xin Xue Guan Bing Za Zhi，2017，45（3）：190-197.

付洁，吴斌，林厚文.伊伐布雷定治疗我国慢性心力衰竭患者的成本-效用分析[J].中国药房，2017，28（32）：4470-4474.

FU J，WU B，LIN H W. Cost-utility analysis of ivabradine in the treatment of chronic heart failure in China[J]. China Pharm，2017，28（32）：4470-4474.

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