Department of Pharmacy, The Second Affiliated Hospital of Soochow University , Suzhou, Jiangsu, China.
Expert Rev Pharmacoecon Outcomes Res. 2020 Aug;20(4):411-418. doi: 10.1080/14737167.2020.1747436. Epub 2020 Apr 4.
This study aimed to assess the efficacy, tolerance, and cost-effectiveness of roxadustat treatment for anemia in patients with chronic kidney disease not receiving dialysis (CKD ND).
A meta-analysis was conducted to evaluate the clinical efficacy and tolerance of roxadustat for the correction of anemia associated with CKD ND, and a Markov model was developed to evaluate the cost-effectiveness of roxadustat compared with a placebo.
The meta-analysis results showed that compared with a placebo, roxadustat treatment was associated with a remarkably higher rate of clinical response and the differences in the rate of adverse events between these two regimens were not significant. Moreover, roxadustat treatment (70 mg, three times per week) provided an additional 0.49 QALYs at a cost of $12,526 in the time horizon of 5 years, resulting in an ICER of $25,563 per QALY, with approximately 60% probability to be cost-effective at a $29,295 per QALY willingness-to-pay (WTP) threshold from the perspective of Chinese medical system.
For the treatment of anemia in Chinese patients with CKD ND, roxadustat is much more effective than a placebo; moreover, it is cost-effective at conventional WTP thresholds.
本研究旨在评估罗沙司他治疗未接受透析的慢性肾脏病（CKD ND）患者贫血的疗效、耐受性和成本效益。
进行了一项荟萃分析，以评估罗沙司他纠正 CKD ND 相关贫血的临床疗效和耐受性，并建立了一个马尔可夫模型来评估罗沙司他与安慰剂相比的成本效益。
荟萃分析结果表明，与安慰剂相比，罗沙司他治疗与更高的临床反应率显著相关，且这两种方案之间不良反应发生率的差异不显著。此外，罗沙司他治疗（每周 70 毫克，三次）在 5 年的时间范围内提供了额外的 0.49 个 QALYs，成本为 12526 美元，导致每 QALY 的 ICER 为 25563 美元，在中国医疗体系的 29295 美元/QALY 意愿支付（WTP）阈值下，大约有 60%的概率具有成本效益。
对于中国 CKD ND 患者贫血的治疗，罗沙司他比安慰剂更有效，而且在常规的 WTP 阈值下具有成本效益。
