中国循证医学杂志

中国循证医学杂志

艾尔巴韦/格拉瑞韦片治疗基因 1b 型慢性丙型肝炎的经济学评价

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目的 价艾尔巴韦/格拉瑞韦片方案与聚乙二醇干扰素联合利巴韦林方案(PR 方案)相比,治疗中国基因 1b 型慢性丙型肝炎患者的卫生经济性。 方法 建立 Markov 模型对两种治疗方案进行成本-效用分析,并对结果进行敏感性分析。 结果 相对于 PR 方案,艾尔巴韦/格拉瑞韦片方案对于无肝硬化患者(13.867 5 QALYs,82 090.82 元 vs. 12.696 2 QALYs,122 791.55 元)和肝硬化患者(12.841 6 QALYs,225 807.70 元 vs. 8.892 4 QALYs,326 545.01 元),均成本更低且效用更高,为绝对优势方案。当阈值从 0 增长到 161 805 元/QALY(约 3 倍中国人均 GDP)时,艾尔巴韦/格拉瑞韦片方案具有经济性的概率接近 100%。 结论 相对于聚乙二醇干扰素联合利巴韦林方案,艾尔巴韦/格拉瑞韦片治疗中国基因 1b 型慢性丙型肝炎更具有卫生经济性。

Objective To determine the health benefit of Elbasvir/Grazoprevir versus peginterferon combing with ribavirin (PR regimen) in Chinese chronic hepatitis C patients with genotype 1b infection. Methods Markov cohort state-transition models were constructed to conduct cost utility analysis, sensitivity analyses were performed based on base-case analysis. Results Elbasvir/Grazoprevir was dominant versus PR, resulting in higher QALYs and lower costs for both noncirrhotic patients (13.867 5 QALYs, 82 090.82 RMB vs. 12.696 2 QALYs, 122 791.55 RMB) and cirrhotic patients (12.841 6 QALYs, 225 807.70 RMB vs. 8.892 4 QALYs, 326 545.01 RMB). Elbasvir/Grazoprevir was economically dominant in nearly 100% among all patients within the range of threshold from 0 to 161 805 RMB/QALY. Conclusion Elbasvir/Grazoprevir was dominant in treatment of genotype 1b chronic hepatitis C infection in China.

关键词: 慢性丙型肝炎; 成本-效用分析; Markov 模型

Key words: Chronic hepatitis C; Cost utility analysis; Markov model

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