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奥马珠单抗治疗中国儿童控制不佳的重度过敏性哮喘的成本效益

Cost-effectiveness of omalizumab for the treatment of inadequately controlled severe allergic asthma in Chinese children.

作者信息

Zhou Hua, Lu Yanming, Wu Bin, Che Datian

机构信息

Department of VIP, Shanghai Children's Hospital, affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Department of Pediatrics, Ren Ji Hospital, South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

出版信息

J Asthma. 2020 Jan;57(1):87-94. doi: 10.1080/02770903.2018.1544642. Epub 2018 Dec 3.

Abstract

The addition of omalizumab to standard therapy has proven to be efficacious in children with severe allergic asthma. The goal of this study was to assess the cost-effectiveness of adding omalizumab to standard treatment for asthma in Chinese pediatric patients. A Markov model was constructed to project the health and economic outcomes in pediatric patients with severe allergic asthma. Model inputs were obtained from the literature. Cost and quality-adjusted life-years (QALYs) were measured over a five-year time horizon. One-way and probabilistic sensitivity analyses were conducted. For the base-case analysis, the addition of omalizumab to standard therapy yielded an incremental cost of $49,047 for 0.232 incremental QALY, led to an incremental cost-effectiveness ratio of $211,217/QALY. Sensitivity analyses were robust for these results. This study found that the addition of omalizumab is not a cost-effective strategy compared with standard therapy for children with severe allergic asthma in China due to its high cost.

摘要

已证明,在标准治疗基础上加用奥马珠单抗对重度过敏性哮喘患儿有效。本研究的目的是评估在中国儿科患者中,在哮喘标准治疗基础上加用奥马珠单抗的成本效益。构建了一个马尔可夫模型,以预测重度过敏性哮喘儿科患者的健康和经济结局。模型输入数据来自文献。在五年时间范围内测量成本和质量调整生命年(QALY)。进行了单向和概率敏感性分析。对于基础病例分析,在标准治疗基础上加用奥马珠单抗产生了49,047美元的增量成本,增量QALY为0.232,导致增量成本效益比为211,217美元/QALY。这些结果的敏感性分析结果稳健。本研究发现,在中国,由于成本高昂,对于重度过敏性哮喘患儿,与标准治疗相比,加用奥马珠单抗并非具有成本效益的策略。

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