唑来膦酸注射液治疗骨质疏松症的成本效果分析在日本。
Cost-effectiveness analysis of once-yearly injection of zoledronic acid for the treatment of osteoporosis in Japan.
机构信息
Department of Medical Statistics, Kobe Pharmaceutical University, 4-19-1, Motoyamakita, Higashinada, Kobe, 658-8558, Japan.
Global Health Research Coordinating Center, Kanagawa Academy of Science and Technology, KSP East 3F 309, 3-2-1, Sakado, Takatsu, Kawasaki, Kanagawa, Japan.
出版信息
Osteoporos Int. 2017 Jun;28(6):1939-1950. doi: 10.1007/s00198-017-3973-8. Epub 2017 Mar 6.
UNLABELLED
Model-based economic evaluation was performed to assess the cost-effectiveness of zoledronic acid. Although zoledronic acid was dominated by alendronate, the incremental quality-adjusted life year (QALY) was quite small in extent. Considering the advantage of once-yearly injection of zoledronic acid in persistence, zoledronic acid might be a cost-effective treatment option compared to once-weekly oral alendronate.
INTRODUCTION
The purpose of this study was to estimate the cost-effectiveness of once-yearly injection of zoledronic acid for the treatment of osteoporosis in Japan.
METHODS
A patient-level state-transition model was developed to predict the outcome of patients with osteoporosis who have experienced a previous vertebral fracture. The efficacy of zoledronic acid was derived from a published network meta-analysis. Lifetime cost and QALYs were estimated for patients who had received zoledronic acid, alendronate, or basic treatment alone. The incremental cost-effectiveness ratio (ICER) of zoledronic acid was estimated.
RESULTS
For patients 70 years of age, zoledronic acid was dominated by alendronate with incremental QALY of -0.004 to -0.000 and incremental cost of 430 USD to 493 USD. Deterministic sensitivity analysis indicated that the relative risk of hip fracture and drug cost strongly affected the cost-effectiveness of zoledronic acid compared to alendronate. Scenario analysis considering treatment persistence showed that the ICER of zoledronic acid compared to alendronate was estimated to be 47,435 USD, 27,018 USD, and 10,749 USD per QALY gained for patients with a T-score of -2.0, -2.5, or -3.0, respectively.
CONCLUSION
Although zoledronic acid is dominated by alendronate, the incremental QALY is quite small in extent. Considering the advantage of annual zoledronic acid treatment in compliance and persistence, zoledronic acid may be a cost-effective treatment option compared to alendronate.
未加标签
采用基于模型的经济评价来评估唑来膦酸的成本效益。虽然唑来膦酸优于阿仑膦酸钠，但增量质量调整生命年（QALY）的幅度相当小。考虑到唑来膦酸每年注射一次在坚持治疗方面的优势，与每周口服阿仑膦酸钠相比，唑来膦酸可能是一种更具成本效益的治疗选择。
引言
本研究旨在评估日本骨质疏松症患者每年接受一次唑来膦酸注射治疗的成本效益。
方法
开发了一个基于患者水平的状态转换模型，以预测经历过椎体骨折的骨质疏松症患者的结局。唑来膦酸的疗效来自已发表的网络荟萃分析。为接受唑来膦酸、阿仑膦酸钠或基础治疗的患者估算了终生成本和 QALY。估算了唑来膦酸的增量成本效益比（ICER）。
结果
对于 70 岁的患者，唑来膦酸劣于阿仑膦酸钠，增量 QALY 为-0.004 至-0.000，增量成本为 430 美元至 493 美元。确定性敏感性分析表明，与阿仑膦酸钠相比，髋部骨折的相对风险和药物成本强烈影响唑来膦酸的成本效益。考虑治疗坚持性的情景分析表明，与阿仑膦酸钠相比，唑来膦酸的 ICER 估计分别为每获得一个 QALY 增加 47435 美元、27018 美元和 10749 美元，对于 T 评分分别为-2.0、-2.5 和-3.0 的患者。
结论
虽然唑来膦酸劣于阿仑膦酸钠，但增量 QALY 的幅度相当小。考虑到唑来膦酸每年治疗的依从性和持久性优势，与阿仑膦酸钠相比，唑来膦酸可能是一种更具成本效益的治疗选择。
Zotero 插件