Mandrik Olena, Knies Saskia, Golubovska Olha, Duda Oleksandr, Dudar Larisa, Fedorchenko Sergiy, Zaliska Olha, Hans Severens J L
Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands.
Dutch Health Care Insurance Board, PO Box 320., 1110 AH Diemen, the Netherlands; Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands.
Open Med (Wars). 2014 Oct 8;10(1):25-33. doi: 10.1515/med-2015-0006. eCollection 2015.
Based on the pivotal trial showing no clinically relevant differences between α-2b (Peg-α-2b) and α-2a (Peg-α-2a) combined with ribavirin for treatment of chronic hepatitis C virus (HCV) genotype 1 infection in Ukraine, a cost-minimization analysis was performed using a 1 year time horizon and both a health care and patients' perspective. A decision tree reflects treatment pathways. Drug costs were based on drug labeling and adjusted to the average body mass in Ukraine. Subgroup analysis was applied to deal with heterogeneity of patient's weight causing dose changes. A break-even price of Peg-α-2a and Peg-α-2b (based on the average dose) was calculated. Univariate sensitivity analyses and probabilistic sensitivity analysis were carried out to reflect decision uncertainty. For an average body weight, total medical costs per patient differ from US$9220 for Peg-α-2b to US$9513 for Peg-α-2a from a health care perspective, and from US$15,212 to US$15,696 from a patients' perspective. Sensitivity analyses show these results are robust. With average body weight, the break-even price of Peg-α-2b may be 7.3% higher than Peg-α-2a to have similar total costs.
在乌克兰进行的一项关键试验表明，α-2b（聚乙二醇化α-2b）和α-2a（聚乙二醇化α-2a）联合利巴韦林治疗慢性丙型肝炎病毒（HCV）1型感染在临床上无显著差异的基础上，采用1年的时间范围并从医疗保健和患者两个角度进行了成本最小化分析。决策树反映了治疗途径。药物成本基于药品标签并根据乌克兰的平均体重进行调整。应用亚组分析来处理因患者体重导致剂量变化的异质性。计算了聚乙二醇化α-2a和聚乙二醇化α-2b（基于平均剂量）的盈亏平衡价格。进行了单因素敏感性分析和概率敏感性分析以反映决策的不确定性。从医疗保健角度来看，对于平均体重的患者，每位患者的总医疗成本从聚乙二醇化α-2b的9220美元到聚乙二醇化α-2a的9513美元不等，从患者角度来看则从15212美元到15696美元不等。敏感性分析表明这些结果是可靠的。对于平均体重，聚乙二醇化α-2b的盈亏平衡价格可能比聚乙二醇化α-2a高7.3%才能具有相似的总成本。
