羧基麦芽糖铁治疗中国缺铁性贫血成人患者的成本-效果分析

孙文韬; 庄铃香; 马爱霞

doi:10.6039/j.issn.1001-0408.2023.22.11

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羧基麦芽糖铁治疗中国缺铁性贫血成人患者的成本-效果分析

药物经济学 | 更新时间：2023-11-25

- 羧基麦芽糖铁治疗中国缺铁性贫血成人患者的成本-效果分析
- Cost-effectiveness analysis of ferric carboxymaltose for treating iron deficiency anemia in adult Chinese patients
- 中国药房 2023年34卷第22期页码：2750-2755
- 作者机构：
  
  1.中国药科大学国际医药商学院，南京;211198
  2.维福费森尤斯卡比（北京）医药信息咨询有限公司，北京　100028
  3.于默奥大学流行病与公共卫生学院，瑞典于默奥　90130
- 作者简介：
  
  博士研究生。研究方向：药物经济学在药品政策中的应用。E-mail：sunwentao0322@163.com
  教授，博士生导师。研究方向：药物经济学、卫生经济与政策。E-mail：aixiama73@126.com
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.22.11
  中图分类号： R956
- 纸质出版日期：2023-11-30，
  
  收稿日期：2023-01-11，
  
  修回日期：2023-10-26，
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孙文韬,庄铃香,马爱霞.羧基麦芽糖铁治疗中国缺铁性贫血成人患者的成本-效果分析[J].中国药房,2023,34(22):2750-2755.

SUN Wentao,ZHUANG Lingxiang,MA Aixia.Cost-effectiveness analysis of ferric carboxymaltose for treating iron deficiency anemia in adult Chinese patients[J].ZHONGGUO YAOFANG,2023,34(22):2750-2755.
孙文韬,庄铃香,马爱霞.羧基麦芽糖铁治疗中国缺铁性贫血成人患者的成本-效果分析[J].中国药房,2023,34(22):2750-2755. DOI： 10.6039/j.issn.1001-0408.2023.22.11.

SUN Wentao,ZHUANG Lingxiang,MA Aixia.Cost-effectiveness analysis of ferric carboxymaltose for treating iron deficiency anemia in adult Chinese patients[J].ZHONGGUO YAOFANG,2023,34(22):2750-2755. DOI： 10.6039/j.issn.1001-0408.2023.22.11.

摘要

目的

评价羧基麦芽糖铁注射液治疗中国缺铁性贫血成人患者的经济性。

方法

从中国卫生体系视角出发，基于一项羧基麦芽糖铁中国Ⅲ期临床试验（NCT03591406）构建分区生存模型，模拟羧基麦芽糖铁和蔗糖铁治疗缺铁性贫血患者的治疗过程及转归，研究时限为1年。计算两种治疗方案的总成本和质量调整生命年（QALYs），并计算增量成本-效果比；对治疗8周之后到研究时限1年之间的疗效参数进行不同假设，基于中国卫生体系和全社会视角进行情境分析，并进行敏感性分析。

结果

基础分析结果显示，与蔗糖铁相比，羧基麦芽糖铁方案的增量效果为0.007 QALYs，费用可节省1 038元，健康产出更高而总成本更低，属于绝对优势方案；情境分析和单因素敏感性分析结果与基础分析一致。概率敏感性分析结果显示，分别以1、2、3倍2022年中国人均国内生产总值为阈值时，羧基麦芽糖铁方案具有经济性的概率为88.2%、94.5%、97.6%。

结论

对于中国缺铁性贫血成人患者来说，与蔗糖铁疗法相比，羧基麦芽糖铁是一种更具经济性的治疗方案。

Abstract

OBJECTIVE

To evaluate the cost-effectiveness of Ferric carboxymaltose injection in the treatment of iron deficiency anemia in adult Chinese patients.

METHODS

From the perspective of China’s health system， the partitioned survival model was constructed to simulate the treatment process and outcome of patients with iron deficiency anemia using ferric carboxymaltose and iron sucrose based on the ferric carboxymaltose phase Ⅲ clinical trial in China （NCT03591406）. The study period was 1 year. Total costs and quality-adjusted life years （QALYs） were calculated for both treatment regimens， and incremental cost-effectiveness ratios were calculated. Scenario analysis was performed with different assumptions for efficacy parameters between 9th week and the end of 1 year， and from the perspective of China’s health system and the entire society. The sensitivity analysis was also performed.

RESULTS

In the basic analysis， compared with iron sucrose， incremental effectiveness of ferric carboxymaltose therapy was 0.007 QALYs， with an additional savings of 1 038 yuan per patient. Ferric carboxymaltose therapy was more effective and less costly， presenting an absolute advantage. The results of the scenario analysis and single-factor sensitivity analysis were consistent with the basic analysis. Probability sensitivity analysis showed that when the willingness-to-pay threshold was 1， 2， 3 times gross domestic product per capita in 2022， the probability of ferric carboxymaltose with a cost-effectiveness advantage was 88.2%，94.5% and 97.6%，respectively.

CONCLUSIONS

For Chinese adults with iron deficiency anemia， ferric carboxymaltose is a cost-effective treatment for iron deficiency anemia， compared with iron sucrose.

关键词

羧基麦芽糖铁注射液缺铁性贫血成本-效果分析分区生存模型

Keywords

iron deficiency anemiacost-effectiveness analysispartitioned survival model

references

JANZ T G，JOHNSON R L，RUBENSTEIN S D. Anemia in the emergency department：evaluation and treatment[J]. Emerg Med Pract，2013，15（11）：1-15；quiz 15-16.

中华医学会血液学分会红细胞疾病（贫血）学组. 静脉铁剂应用中国专家共识：2019年版[J]. 中华血液学杂志，2019，40（5）：358-362.

Red Blood Cell Diseases（Anemia）Group，Chinese Society of Hematology，Chinese Medical Association. Chinese expert consensus on the application of intravenous iron：2019[J].Chin J Hematol，2019，40（5）：358-362.

中华医学会血液学分会红细胞疾病（贫血）学组. 铁缺乏症和缺铁性贫血诊治和预防多学科专家共识[J]. 中华医学杂志，2018，98（28）：2233-2237.

Red Blood Cell Diseases（Anemia）Group，Chinese Society of Hematology，Chinese Medical Association. Multidisciplinary expert consensus on the diagnosis，treatment and prevention of iron deficiency and iron deficiency anemia[J]. Natl Med J China，2018，98（28）：2233-2237.

KOZEK-LANGENECKER S A，AFSHARI A，ALBALADEJO P，et al. Management of severe perioperative bleeding：guidelines from the European Society of Anaesthesiology[J]. Eur J Anaesthesiol，2013，30（6）：270-382.

MEUNIER-MCVEY N. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. EMJ Cardiol，2021：22-25.

肖若薇，李薇，孙文韬，等. 使用静脉铁剂的住院患者贫血治疗现状真实世界研究[J]. 临床药物治疗杂志，2022，20（6）：67-71.

XIAO R W，LI W，SUN W T，et al. Current status of anemia treatment in inpatients treated with intravenous iron：a real-world study[J]. Clin Med J，2022，20（6）：67-71.

ClinicalTrials.gov. To assess the impact of ferric carboxymaltose compared with iron sucrose in Chinese subjects on correcting iron deficiency anemia[EB/OL]. [2023-05-14]. https：//www.clinicaltrials.gov/ct2/show/NCT03591406?Term=NCT03591406&draw=2&rank=1https://www.clinicaltrials.gov/ct2/show/NCT03591406?Term=NCT03591406&draw=2&rank=1.

金洁，冉志华. 一项在中国人群中评估羧基麦芽糖铁与蔗糖铁相比治疗缺铁性贫血的开放性、随机对照多中心3期研究[C]//2022中华医学会第十七次全国血液学学术会议，上海：中华医学会，2022.

JIN J，RAN Z H. An open，randomised controlled multicentre phase 3 trial evaluating ferric carboxymaltose compared with iron sucrose for the treatment of iron deficiency anaemia in the Chinese population[C]//The 17th National Hematology Symposium of the Chinese Medical Association，2022，Shanghai：Chinese Medical Association，2022.

LATIMER N R. Survival analysis for economic evalu-ations alongside clinical trials：extrapolation with patient-level data[M]. London：National Institute for Health and Care Excellence（NICE），2013：1.

CALVET X，GENÉ E，ÀNGELRUÍZ M，et al. Cost-minimization analysis favours intravenous ferric carboxymaltose over ferric sucrose or oral iron as preoperative treatment in patients with colon cancer and iron deficiency anaemia[J]. Technol Health Care，2016，24（1）：111-120.

BISBE E，GARCÍA-ERCE J A，DÍEZ-LOBO A I，et al. A multicentre comparative study on the efficacy of intravenous ferric carboxymaltose and iron sucrose for correcting preoperative anaemia in patients undergoing major elective surgery[J]. Br J Anaesth，2011，107（3）：477-478.

ROGNONI C，ORTALDA V，BIASI C，et al. Economic evaluation of ferric carboxymaltose for the management of hemodialysis patients with iron deficiency anemia in Italy[J]. Adv Ther，2019，36（11）：3253-3264.

LACQUANITI A，PASQUALETTI P，TOCCO T C D，et al. Ferric carboxymaltose versus ferric gluconate in hemodialysis patients：reduction of erythropoietin dose in 4 years of follow-up[J]. Kidney Res Clin Pract，2020，39（3）：334-343.

HOFMAN J M G，EISENGA M F，DIEPENBROEK A，et al. Switching iron sucrose to ferric carboxymaltose asso-ciates to better control of iron status in hemodialysis patients[J]. BMC Nephrol，2018，19（1）：242.

CALLEJA J L，DELGADO S，DEL VAL A，et al. Ferric carboxymaltose reduces transfusions and hospital stay in patients with colon cancer and anemia[J]. Int J Colorectal Dis，2016，31（3）：543-551.

FROESSLER B，PALM P，WEBER I，et al. Reply：the important role for intravenous iron in perioperative patient blood management in major abdominal surgery：a rando-mized controlled trial[J]. Ann Surg，2018，267（3）：e49-e50.

KHALAFALLAH A A，YAN C，AL-BADRI R，et al. Intravenous ferric carboxymaltose versus standard care in the management of postoperative anaemia：a prospective，open-label，randomised controlled trial[J]. Lancet Haematol，2016，3（9）：e415-e425.

SPAHN D R，SCHOENRATH F，SPAHN G H，et al. Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery：a prospective randomised trial[J]. Lancet，2019，393（10187）：2201-2212.

KIM S K，SEO W Y，KIM H J，et al. Postoperative intravenous ferric carboxymaltose reduces transfusion amounts after orthopedic hip surgery[J]. Clin Orthop Surg，2018，10（1）：20-25.

STRAUSS W E，AUERBACH M. Health-related quality of life in patients with iron deficiency anemia：impact of treatment with intravenous iron[J]. Patient Relat Outcome Meas，2018，9：285-298.

YANG Z H，BUSSCHBACH J，LIU G，et al. EQ-5D-5L norms for the urban Chinese population in China[J]. Health Qual Life Outcomes，2018，16（1）：210.

WU D，ZHANG Y，BOEGELUND M，et al. PR4 health utility assessment of different options for treatment of iron deficiency anemia：results from time-trade-off study in China[J]. Value Health，2021，24：S197.

官海静，周宗科，刘腾，等. 不同蔗糖铁注射液用于骨科围手术期贫血的效果及费用比较[J]. 临床药物治疗杂志，2022，20（4）：32-36.

GUAN H J，ZHOU Z K，LIU T，et al. Effectiveness and medical expenditure of iron sucrose in the treatment of iron deficiency anemia during perioperative period of orthopedic surgery[J]. Clin Med J，2022，20（4）：32-36.

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