Department of Pharmacy, Fuwai Yunnan Cardiovascular Hospital, Affiliated with the Kunming Medical University, Kunming, China.
Department of Pharmacy, Ren Ji Hospital, South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Adv Ther. 2018 Dec;35(12):2214-2223. doi: 10.1007/s12325-018-0823-9. Epub 2018 Nov 2.
Statins can reduce the risk of cardiovascular events in patients with diabetes. The objective of this analysis was to evaluate whether primary prevention with statin treatment is cost-effective for newly diagnosed type 2 diabetes mellitus (T2DM) patients in the Chinese context.
An economic analysis of primary prevention with statin treatment was conducted using the Chinese Outcomes Model for T2DM with a time horizon of a lifetime, which was developed and validated based on the Chinese population. Clinical costs and utility inputs were gathered from published sources. Lifetime discounted quality-adjusted life-years (QALYs), costs, and the incremental cost-effectiveness ratio (ICER) were measured. The uncertainty was evaluated by one-way and probabilistic sensitivity analyses.
Statin treatment with atorvastatin 10 mg could add 0.08 QALYs with an additional $1676 compared with that of no statin management (control strategy) over a lifetime horizon, which led to an ICER of $21,924 per QALY gained. At a willingness-to-pay threshold of $27,351 per QALY gained, there was an approximately 80% probability of statin treatment being cost-effective compared with the control strategy. The model outcomes were most sensitive to the length of the expected life and age at the T2DM diagnosis.
Statin treatment with atorvastatin is most likely cost-effective for primary prevention in Chinese patients newly diagnosed with type 2 diabetes.
Partially funded by Pfizer Inc.
他汀类药物可降低糖尿病患者发生心血管事件的风险。本分析旨在评估在中国背景下，对于新诊断的 2 型糖尿病（T2DM）患者，采用他汀类药物进行一级预防治疗是否具有成本效益。
使用基于中国人群开发和验证的 T2DM 中国结局模型（China Outcomes Model for T2DM，COMET-T2DM）进行一级预防治疗的经济分析，该模型的时间范围为终身。临床成本和效用输入数据来源于已发表的研究。测量了终身贴现后的质量调整生命年（QALY）、成本和增量成本效益比（ICER）。通过单因素敏感性分析和概率敏感性分析评估了不确定性。
阿托伐他汀 10mg 进行他汀类药物治疗，与不进行他汀类药物管理（对照策略）相比，在终身范围内可增加 0.08 个 QALY，额外花费 1676 美元，导致每获得一个 QALY 的增量成本效益比为 21924 美元。在愿意支付的每获得一个 QALY 为 27351 美元的阈值下，他汀类药物治疗与对照策略相比，具有成本效益的可能性约为 80%。模型结果对预期寿命和 T2DM 诊断时的年龄这两个因素最为敏感。
对于新诊断为 2 型糖尿病的中国患者，采用阿托伐他汀进行他汀类药物一级预防治疗可能具有成本效益。
部分由辉瑞公司资助。
