- Journal Information
- Archive
- Submission
- For Reviewers
- Statement and Policies
- 个人中心
- 退出登录
浏览全部资源
扫码关注微信
- Journal Information
- Journal Introduction
- Editorial Board
- Youth Editorial Board
- Editorial Board Charter
- Subscriptions
- Archive
- Current Issue
- Past Issues
- Priority Publication
- Virtual Collection
- Recommended Articles
- Submission
- Submission Process
- Submission Guidelines
- Download
- Contact us
- For Reviewers
- Guidelines for Reviewers
- Peer Reviewed Policies
- Statement and Policies
- Ethics and Malpractice
- Research Ethics Policies
- Repetition Detection
- Corrections and Retractions
- Editorial Policies
- Open Access Statement
- Website Responsibility
Cost-utility analysis of 5 kinds of GLP-1RAs in the treatment of poorly controlled type 2 diabetes mellitus treated with metformin
- ZHONGGUO YAOFANG Vol. 35, Issue 6, Pages: 718-723(2024)
- 作者机构：
广东药科大学附属第一医院临床药学重点专科，广州 510030
- 作者简介：
- 基金信息：
DOI：10.6039/j.issn.1001-0408.2024.06.14
CLC： R956Received：09 November 2023，
Revised：2024-03-04，
Accepted：05 March 2024，
Published：30 March 2024
- 稿件说明：
移动端阅览
谢泽宇,李梦婷,胡佳,等.5种GLP-1RAs治疗二甲双胍控制不佳的2型糖尿病的成本-效用分析[J].中国药房,2024,35(06):718-723.
XIE Zeyu,LI Mengting,HU Jia,et al.Cost-utility analysis of 5 kinds of GLP-1RAs in the treatment of poorly controlled type 2 diabetes mellitus treated with metformin[J].ZHONGGUO YAOFANG,2024,35(06):718-723.
谢泽宇,李梦婷,胡佳,等.5种GLP-1RAs治疗二甲双胍控制不佳的2型糖尿病的成本-效用分析[J].中国药房,2024,35(06):718-723. DOI： 10.6039/j.issn.1001-0408.2024.06.14.
XIE Zeyu,LI Mengting,HU Jia,et al.Cost-utility analysis of 5 kinds of GLP-1RAs in the treatment of poorly controlled type 2 diabetes mellitus treated with metformin[J].ZHONGGUO YAOFANG,2024,35(06):718-723. DOI： 10.6039/j.issn.1001-0408.2024.06.14.
摘要
目的
2
评估5种胰高血糖素样肽-1受体激动剂（GLP-1RAs）治疗二甲双胍控制血糖不佳的2型糖尿病（T2DM）的长期经济性。
方法
2
提取既往发表的荟萃分析及其纳入的随机对照研究（RCT）中患者的基线数据，使用英国前瞻性糖尿病研究结果模型2.1预测各组患者的生存情况、长期疗效和成本，采用成本-效用分析法比较5种GLP-1RAs（利拉鲁肽、利司那肽、艾塞那肽、度拉糖肽和司美格鲁肽）的经济性；采用敏感性分析和情境分析验证基础分析结果的稳定性。
结果
2
共纳入21项RCT，6 796名患者。生存曲线表明，司美格鲁肽在降低因心血管疾病死亡风险上、度拉糖肽在降低全因死亡风险上较其他GLP-1RAs具有优势。成本-效用分析结果显示，5种方案的经济性从优到劣排序依次为利司那肽、司美格鲁肽、艾塞那肽、度拉糖肽和利拉鲁肽。单因素敏感性分析和概率敏感性分析表明基础分析结果稳健。情境分析结果显示，司美格鲁肽的价格至少降低54.64%，降至369.21元，其对比利司那肽才具有经济性。
结论
2
对于使用二甲双胍治疗后血糖控制不佳的我国T2DM患者，临床可考虑优先选择利司那肽和司美格鲁肽。
Abstract
OBJECTIVE
2
To assess the long-term cost-effectiveness of five glucagon-like peptide-1 receptor agonists （GLP-1RAs） in the treatment of poorly controlled type 2 diabetes mellitus （T2DM） treated with metformin.
METHODS
2
Baseline data from patients in previously published meta-analysis and included randomized controlled trials （RCTs） were extracted to predict survival， long-term efficacy， and costs for each group using the United Kingdom prospective diabetes study outcome model 2.1. The cost-effectiveness of 5 GLP-1RAs （liraglutide， lixisenatide， exenatide， dulaglutide， and semaglutide） was analyzed by cost-utility analysis. Sensitivity analysis and scenario analysis were also performed to verify the uncertainty of basic analysis results.
RESULTS
2
A total of 21 RCTs with 6 796 patients were included. Survival analysis curves showed the superiority of semaglutide in reducing the risk of death from cardiovascular disease and dulaglutide in reducing the risk of all-cause mortality over other GLP-1RAs. The cost-utility analysis showed that the five drugs were economically superior to inferior in the order of lixisenatide， semaglutide， exenatide， dulaglutide， and liraglutide； one-way and probabilistic sensitivity analyses indicated that the results were robust. The scenario analysis results indicated that the price of semaglutide should decrease by at least 54.64% to 369.21 yuan， which is cost-effectiveness compared to lixisenatide.
CONCLUSIONS
2
For T2DM patients in China with poor glycemic control after treatment with metformin， lixisenatide and semaglutide may be considered as the preferred regimen.
关键词
Keywords
references
American Diabetes Association . Economic costs of diabetes in the U.S. in 2017 [J ] . Diabetes Care ， 2018 ， 41 （ 5 ）： 917 - 928 .
WANG L ， PENG W ， ZHAO Z ， et al . Prevalence and treatment of diabetes in China，2013-2018 [J ] . JAMA ， 2021 ， 326 （ 24 ）： 2498 - 2506 .
LIU J L ， LIU M ， CHAI Z L ， et al . Projected rapid growth in diabetes disease burden and economic burden in China：a spatio-temporal study from 2020 to 2030 [J ] . Lancet Reg Health West Pac ， 2023 ， 33 ： 100700 .
《中国老年型糖尿病防治临床指南》编写组 . 中国老年2型糖尿病防治临床指南：2022年版 [J ] . 中国糖尿病杂志 ， 2022 ， 30 （ 1 ）： 2 - 51 .
Writing Group of Clinical Guidelines for the Prevention and Treatment of Type 2 Diabetes in the Elderly in China . Clinical guidelines for the prevention and treatment of type 2 diabetes in the elderly in China：2022 edition [J ] . Chin J Diabetes ，2022， 30 （ 1 ）： 2 - 51 .
WANG L M ， GAO P ， ZHANG M ， et al . Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013 [J ] . JAMA ， 2017 ， 317 （ 24 ）： 2515 - 2523 .
ALI M K ， BULLARD K M ， SAYDAH S ， et al . Cardiovascular and renal burdens of prediabetes in the USA：analysis of data from serial cross-sectional surveys，1988-2014 [J ] . Lancet Diabetes Endocrinol ， 2018 ， 6 （ 5 ）： 392 - 403 .
PAN Y S ， CHEN W Q ， WANG Y J . Prediabetes and outcome of ischemic stroke or transient ischemic attack：a systematic review and meta-analysis [J ] . J Stroke Cerebrovasc Dis ， 2019 ， 28 （ 3 ）： 683 - 692 .
HUANG Y L ， CAI X Y ， MAI W Y ， et al . Association between prediabetes and risk of cardiovascular disease and all cause mortality：systematic review and meta-analysis [J ] . BMJ ， 2016 ， 355 ： i5953 .
MOSENZON O ， ALGUWAIHES A ， LEON J L A ， et al . CAPTURE：a multinational，cross-sectional study of cardiovascular disease prevalence in adults with type 2 diabetes across 13 countries [J ] . Cardiovasc Diabetol ， 2021 ， 20 （ 1 ）： 154 .
中华医学会糖尿病学分会 . 中国2型糖尿病防治指南：2020年版 [J ] . 国际内分泌代谢杂志 ， 2021 ， 41 （ 5 ）： 482 - 548 .
Chinese Medical Association ， Diabetes Branch . Guideline for the prevention and treatment of type 2 diabetes mellitus in China：2020 edition [J ] . Int J Endocrinol Metab ， 2021 ， 41 （ 5 ）： 482 - 548 .
American Diabetes Association . Introduction：standards of medical care in diabetes：2022 [J ] . Diabetes Care ， 2022 ， 45 （ Suppl 1 ）： S1 - S2 .
XIE Z Y ， HU J ， GU H Y ， et al . Comparison of the efficacy and safety of 10 glucagon-like peptide-1 receptor agonists as add-on to metformin in patients with type 2 diabetes：a systematic review [J ] . Front Endocrinol ， 2023 ， 14 ： 1244432 .
HAYES A J ， LEAL J ， GRAY A M ， et al . UKPDS outcomes model 2：a new version of a model to simulate lifetime health outcomes of patients with type 2 diabetes mellitus using data from the 30-year United Kingdom Prospective Diabetes Study：UKPDS 82 [J ] . Diabetologia ， 2013 ， 56 （ 9 ）： 1925 - 1933 .
World Health Organization . The world health report 2002 [J ] . Midwifery ， 2003 ， 19 （ 1 ）： 72 - 73 .
GAO L ， ZHAO F L ， LI S C . Cost-utility analysis of liraglutide versus glimepiride as add-on to metformin in type 2 diabetes patients in China [J ] . Int J Technol Assess Health Care ， 2012 ， 28 （ 4 ）： 436 - 444 .
BERTRAM M Y ， LAUER J A ， DE JONCHEERE K ， et al . Cost-effectiveness thresholds：pros and cons [J ] . Bull World Health Organ ， 2016 ， 94 （ 12 ）： 925 - 930 .
LI X ， XU Z R ， JI L N ， et al . Direct medical costs for patients with type 2 diabetes in 16 tertiary hospitals in urban China：a multicenter prospective cohort study [J ] . J Diabetes Investig ， 2019 ， 10 （ 2 ）： 539 - 551 .
SU W ， LI C Y ， ZHANG L ， et al . Meta-analysis and cost-effectiveness analysis of insulin glargine 100 U/mL versus insulin degludec for the treatment of type 2 diabetes in China [J ] . Diabetes Ther ， 2019 ， 10 （ 5 ）： 1969 - 1984 .
DENG J ， GU S Y ， SHAO H ， et al . Cost-effectiveness analysis of exenatide twice daily（bid）vs insulin glargine once daily（qd）as add-on therapy in Chinese patients with type 2 diabetes mellitus inadequately controlled by oral therapies [J ] . J Med Econ ， 2015 ， 18 （ 11 ）： 974 - 989 .
CAI X L ， SHI L Z ， YANG W J ， et al . Cost-effectiveness analysis of dapagliflozin treatment versus metformin treatment in Chinese population with type 2 diabetes [J ] . J Med Econ ， 2019 ， 22 （ 4 ）： 336 - 343 .
HOU X Y ， WAN X ， WU B . Cost-effectiveness of canagliflozin versus dapagliflozin added to metformin in patients with type 2 diabetes in China [J ] . Front Pharmacol ， 2019 ， 10 ： 480 .
WU B ， WAN X ， MA J . Cost-effectiveness of prevention and management of diabetic foot ulcer and amputation in a health resource-limited setting [J ] . J Diabetes ， 2018 ， 10 （ 4 ）： 320 - 327 .
PAN C W ， SUN H P ， ZHOU H J ， et al . Valuing health-related quality of life in type 2 diabetes patients in China [J ] . Med Decis Making ， 2016 ， 36 （ 2 ）： 234 - 241 .
CURRIE C J ， MCEWAN P ， PETERS J R ， et al . The routine collation of health outcomes data from hospital treated subjects in the Health Outcomes Data Repository（HODaR）：descriptive analysis from the first 20 000 subjects [J ] . Value Health ， 2005 ， 8 （ 5 ）： 581 - 590 .
CLARKE P ， GRAY A ， HOLMAN R . Estimating utility values for health states of type 2 diabetic patients using the EQ-5D（UKPDS 62） [J ] . Med Decis Making ， 2002 ， 22 （ 4 ）： 340 - 349 .
姚嘉奇 ， 管欣 ， 张瑶 ， 等 . 药物经济学概率敏感性分析中关联参数的处理与实践探讨 [J ] . 中国药物评价 ， 2019 ， 36 （ 2 ）： 150 - 155 .
YAO J Q ， GUAN X ， ZHANG Y ， et al . Discussion and practice of correlating parameters in sensitivity analysis of pharmacoeconomics [J ] . Chin J Drug Eval ， 2019 ， 36 （ 2 ）： 150 - 155 .
0
Views
201
下载量
0
CSCD
- L-PDFDownload
- WORDDownload
- Meta-XMLDownload
- BibTeXDownload
- EndnoteDownload
- RefMan Download
- NoteExpressDownload
- NoteFirstDownload
Publicity Resources
Related Articles
Related Author
Related Institution
- Address：8th Floor, Sihuan Building, No. 129 Daping Main Street, Yuzhong District, Chongqing, China Postal code：400042
- Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号
公网安备50010302001817 - It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
- Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.