Nuijten Mark J C, Hutton John
MEDTAP International, Dorpsstraat 75, 1546 LG Jisp, Amsterdam, Netherlands.
Value Health. 2002 Jan-Feb;5(1):44-54. doi: 10.1046/j.1524-4733.2002.51052.x.
The objective of this study was to examine the cost-effectiveness of preventive treatment with interferon beta (IFNB) versus no preventive treatment in patients with multiple sclerosis.
The setting for this study was the United Kingdom. A lifetime Markov process model was constructed to model the average quality-adjusted life years (QALYs) and the costs of both treatment strategies. Data for the construction of the model came from published literature, including large multicenter randomized clinical trials in relapsing-remitting and secondary progressive multiple sclerosis. Costs were obtained from published sources.
The results of the baseline analysis from the National Health Service (NHS) perspective showed that the use of interferon beta as preventive treatment for MS increased the total average discounted cost from 51,214 Pounds to 221,436 Pounds per patient. The undiscounted effectiveness increased from 24.9 QALYs to 28.2 QALYs, resulting in an incremental cost-effectiveness ratio of 51,582 Pounds per QALY. Sensitivity analyses showed the robustness of this model for other interferons.
The study showed that preventive treatment with interferon beta in patients with multiple sclerosis may not be fully justified from a health-economic perspective, although interferon beta is associated with an improved effectiveness compared with no preventive treatment.
本研究旨在探讨在多发性硬化症患者中，使用β-干扰素（IFNB）进行预防性治疗与不进行预防性治疗相比的成本效益。
本研究以英国为背景。构建了一个终生马尔可夫过程模型，以模拟两种治疗策略的平均质量调整生命年（QALY）和成本。构建模型的数据来自已发表的文献，包括复发缓解型和继发进展型多发性硬化症的大型多中心随机临床试验。成本来自已发表的资料。
从英国国家医疗服务体系（NHS）的角度进行的基线分析结果显示，使用β-干扰素作为多发性硬化症的预防性治疗，每位患者总平均贴现成本从51,214英镑增加到221,436英镑。未贴现的有效性从24.9 QALY增加到28.2 QALY，导致每QALY的增量成本效益比为51,582英镑。敏感性分析表明该模型对其他干扰素具有稳健性。
该研究表明，从健康经济学角度来看，在多发性硬化症患者中使用β-干扰素进行预防性治疗可能并不完全合理，尽管与不进行预防性治疗相比，β-干扰素与有效性提高相关。
