富马酸二甲酯治疗复发型多发性硬化的最小成本分析

李伟; 孙轶竹; 方佳; 殷剑

doi:10.6039/j.issn.1001-0408.2022.24.12

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富马酸二甲酯治疗复发型多发性硬化的最小成本分析

药物经济学 | 更新时间：2023-02-22

- 富马酸二甲酯治疗复发型多发性硬化的最小成本分析
- Cost-minimization analysis of dimethyl fumarate in the treatment of relapsing multiple sclerosis
- 中国药房 2022年33卷第24期页码：3005-3009
- 作者机构：
  
  1.中国药科大学国际医药商学院，南京　211198
  2.天津开心生活科技有限公司，上海　200030
  3.中国医学科学院老年医学研究院，北京　100730
- 作者简介：
  
  副教授，博士。研究方向：医药市场准入与药物经济学。E-mail：cpuliwei@163.com
  主任医师。研究方向：神经免疫学。E-mail：m13611177824@163.com
- 基金信息：
  
  基金项目中国药科大学“双一流”建设项目(No.CPU2018-GY41)
- DOI：10.6039/j.issn.1001-0408.2022.24.12
  中图分类号： R956
- 纸质出版日期：2022-12-30，
  
  收稿日期：2022-05-03，
  
  修回日期：2022-09-08，
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李伟,孙轶竹,方佳等.富马酸二甲酯治疗复发型多发性硬化的最小成本分析^Δ[J].中国药房,2022,33(24):3005-3009.

LI Wei,SUN Yizhu,FANG Jia.Cost-minimization analysis of dimethyl fumarate in the treatment of relapsing multiple sclerosis[J].ZHONGGUO YAOFANG,2022,33(24):3005-3009.
李伟,孙轶竹,方佳等.富马酸二甲酯治疗复发型多发性硬化的最小成本分析^Δ[J].中国药房,2022,33(24):3005-3009. DOI： 10.6039/j.issn.1001-0408.2022.24.12.

LI Wei,SUN Yizhu,FANG Jia.Cost-minimization analysis of dimethyl fumarate in the treatment of relapsing multiple sclerosis[J].ZHONGGUO YAOFANG,2022,33(24):3005-3009. DOI： 10.6039/j.issn.1001-0408.2022.24.12.

摘要

目的

评估富马酸二甲酯对比芬戈莫德治疗复发型多发性硬化（RMS）的经济性。

方法

从我国卫生体系角度出发，采用最小成本分析法评估富马酸二甲酯对比芬戈莫德治疗RMS的经济性。模型研究时限为2年，贴现率为5%。成本包括药品费用、治疗监测费用和不良反应处理费用，相关参数来自公开发表的文献、政府公开文件及专家访谈。对基础分析结果进行单因素敏感性分析，对模型研究时限进行情境分析。

结果

在已有的临床研究中，不同维度的间接Meta分析结果均显示，富马酸二甲酯和芬戈莫德在临床疗效上类似。在模型模拟的2年内，患者接受富马酸二甲酯治疗所花费的平均总成本为91 756.3元，接受芬戈莫德的患者所花费的平均总成本为163 761.5元，前者的医疗费用支出比后者平均减少了72 005.2元。将研究时限延长至3年，接受富马酸二甲酯治疗的患者的医疗费用支出比接受芬戈莫德治疗的患者平均减少了105 420.8元。对基础分析结果影响最大的因素为芬戈莫德的药品治疗费用。在敏感性分析的参数浮动范围内，增量成本均为负数，表明基础分析结果稳健。

结论

基于我国卫生体系角度，富马酸二甲酯治疗RMS比芬戈莫德更具经济性。

Abstract

OBJECTIVE

To evaluate the cost-effectiveness of dimethyl fumarate versus fingolimod in the treatment of relapsing multiple sclerosis （RMS）.

METHODS

The cost-effectiveness of dimethyl fumarate versus fingolimod in the treatment of RMS was evaluated with cost-minimization analysis from the perspective of China’s health system. The research period of the model was 2 years， and the discount rate was 5%. Costs included drug costs， treatment monitoring costs and adverse reaction disposal costs. Relevant parameters were from published literature， government documents and expert interviews. A one-way sensitivity analysis of the results and a scenario analysis of the model duration were performed.

RESULTS

In existing clinical studies， indirect meta-analysis results of different dimensions showed that dimethyl fumarate and fingolimod were similar in clinical efficacy. Within 2 years of the model simulation， total cost per patient using dimethyl fumarate was 91 756.3 yuan and that of using fingolimod was 163 761.5 yuan. The use of dimethyl fumarate was associated with savings of 72 005.2 yuan compared with fingolimod. When extending study horizon to 3 years， the cost savings with the use of dimethyl fumarate increased to 105 420.8 yuan， compared with fingolimod. The most influential factor on the results of the basic analysis was the drug treatment cost of fingolimod. Within the parameter fluctuation range of sensitivity analysis， the incremental costs were all negative， and the basic analysis results were robust.

CONCLUSIONS

Based on a health system perspective， dimethyl fumarate is more cost-effective than fingolimod in the treatment of RMS.

关键词

富马酸二甲酯芬戈莫德复发型多发性硬化最小成本分析法

Keywords

fingolimodrelapsing multiple sclerosiscost-minimization analysis

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