复发缓解型多发性硬化症不同治疗策略的成本效益
Cost-effectiveness of different strategies for treatment relapsing-remitting multiple sclerosis.
作者信息
Sawad Aseel Bin, Seoane-Vazquez Enrique, Rodriguez-Monguio Rosa, Turkistani Fatema
机构信息
International Center for Pharmaceutical Economics & Policy, MCPHS University, Boston, MA, USA.
Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia.
出版信息
J Comp Eff Res. 2017 Mar;6(2):97-108. doi: 10.2217/cer-2016-0056. Epub 2017 Jan 25.
AIM
To compare the cost-effectiveness of different disease-modifying therapies' strategies for treatment of relapsing-remitting multiple sclerosis.
METHODS
A Markov model was developed to assess the cost-effectiveness and incremental cost-effectiveness ratios for different strategies of using disease-modifying therapies from a US third-party payer perspective. All costs were converted to 2014 US$.
RESULTS
Over 20 years, the total costs per patient were estimated at US$161,136.60 for Strategy 1 (symptom management [SM] alone), US$551,650.66 for Strategy 2 (SM and IFN-β-1a), US$703,463.60 for Strategy 3 (SM and natalizumab) and US$670,985.24 for Strategy 4 (SM and alemtuzumab). The accumulated quality-adjusted life years were 10.49, 10.66, 10.69 and 10.71 for each of the four Strategies 1-4, respectively. The resulting incremental cost-effectiveness ratios were 2,297,141.53 comparing Strategy 2 to Strategy 1, and -1,623,918.00 comparing Strategy 4 to Strategy 3.
CONCLUSION
Strategy 1 was the cost-effective strategy for treatment of relapsing-remitting multiple sclerosis when compared with other strategies.
目的
比较不同疾病修正治疗策略治疗复发缓解型多发性硬化症的成本效益。
方法
建立马尔可夫模型，从美国第三方支付方的角度评估使用疾病修正治疗的不同策略的成本效益和增量成本效益比。所有成本均换算为2014年美元。
结果
20年间，策略1（仅症状管理[SM]）每位患者的总成本估计为161,136.60美元，策略2（SM和干扰素-β-1a）为551,650.66美元，策略3（SM和那他珠单抗）为703,463.60美元，策略4（SM和阿仑单抗）为670,985.24美元。四种策略1 - 4各自的累积质量调整生命年分别为10.49、10.66、10.69和10.71。将策略2与策略1比较，所得增量成本效益比为2,297,141.53，将策略4与策略3比较为 - 1,623,918.00。
结论
与其他策略相比，策略1是治疗复发缓解型多发性硬化症的成本效益策略。
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