Chen Shunan, Mao Fengqian, Hu Yani, Wang Suhong, Chen Jie, Zhang Jiali, Yu Lingyan, Dai Haibin
School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China.
Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
Int J Clin Pharm. 2025 Apr;47(2):373-381. doi: 10.1007/s11096-024-01838-3. Epub 2024 Dec 1.
Clobazam (CLB) is an effective, safe and well-tolerated adjunctive treatment for refractory epilepsy. However, the cost-effectiveness of CLB in China remains unclear.
The aim of this study was to evaluate the cost-effectiveness of CLB as an adjunctive therapy for patients with refractory epilepsy in China.
A Markov model was established to simulate the lifetime epilepsy process in patients. The epilepsy remission rate, health state utility and mortality data were derived from clinical trials and the literature. The costs were collected from the health care system in the hospital. The primary outcome was the incremental cost-effectiveness ratio (ICER), which was calculated by comparing CLB as an add-on therapy with conventional therapy and was assessed in the context of the Chinese health system. One-way and probabilistic sensitivity analyses were conducted to evaluate parameter uncertainty, and several scenario analyses were also conducted.
Compared with maintaining conventional therapy, adding CLB as an adjuvant therapy increased the cost of Chinese Yuan (CNY) 1770.17 over a lifetime, with an incremental quality-adjusted life years (QALYs) value of 1.02, resulting in an ICER of CNY 1737.10 per QALY gained. The daily dose of CLB had the strongest effect on the ICER. The probabilistic sensitivity analyses revealed that the probability of CLB being cost-effective was 77.35% at a willingness to pay (WTP) of CNY 85698/QALY.
CLB is a cost-effective add-on therapy for refractory epilepsy in the Chinese population.
氯巴占（CLB）是难治性癫痫一种有效、安全且耐受性良好的辅助治疗药物。然而，氯巴占在中国的成本效益仍不明确。
本研究旨在评估氯巴占作为中国难治性癫痫患者辅助治疗的成本效益。
建立马尔可夫模型以模拟患者的终生癫痫病程。癫痫缓解率、健康状态效用值和死亡率数据来源于临床试验及文献。成本从医院医疗保健系统收集。主要结局指标为增量成本效益比（ICER），通过将氯巴占作为附加治疗与传统治疗进行比较计算得出，并在中国卫生系统背景下进行评估。进行单向和概率敏感性分析以评估参数不确定性，还进行了几种情景分析。
与维持传统治疗相比，添加氯巴占作为辅助治疗在终生期间增加成本1770.17元，增量质量调整生命年（QALY）值为1.02，导致每获得一个QALY的ICER为1737.10元。氯巴占的日剂量对ICER影响最大。概率敏感性分析显示，在支付意愿（WTP）为85698元/QALY时，氯巴占具有成本效益的概率为77.35%。
氯巴占是中国人群难治性癫痫一种具有成本效益的附加治疗药物。
