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评估去铁胺麦芽糖铁与羧基麦芽糖铁对挪威炎症性肠病合并缺铁性贫血患者的成本效益。

Evaluating the cost-utility of ferric derisomaltose versus ferric carboxymaltose in patients with inflammatory bowel disease and iron deficiency anaemia in Norway.

作者信息

Detlie T E, Karlsen L N, Jørgensen E, Nanu N, Pollock R F

机构信息

Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway.

Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.

出版信息

J Med Econ. 2025 Dec;28(1):291-301. doi: 10.1080/13696998.2024.2444833. Epub 2025 Feb 17.

Abstract

AIMS

Iron deficiency anemia (IDA) is among the most common extraintestinal sequelae of inflammatory bowel disease (IBD). Intravenous iron is often the preferred treatment in patients with active inflammation with or without active bleeding, iron malabsorption, or intolerance to oral iron. The aim of the present study was to evaluate the cost-utility of ferric derisomaltose (FDI) versus ferric carboyxymaltose (FCM) in patients with IBD and IDA in Norway.

MATERIALS AND METHODS

A published patient-level simulation model was used to evaluate the cost-utility of FDI versus FCM in patients with IBD and IDA from a Norwegian national payer perspective. Iron need was modelled based on bivariate distributions of hemoglobin and bodyweight combined with simplified tables of iron need from the FDI and FCM summaries of product characteristics. Patient characteristics and disease-related quality of life data were obtained from the PHOSPHARE-IBD trial. Cost-utility was evaluated in Norwegian Kroner (NOK) over a five-year time horizon.

RESULTS

Patients required 1.64 fewer infusions of FDI than FCM over five years (5.62 versus 7.26), corresponding to 0.41 fewer infusions per treatment course. The reduction in the number of infusions resulted in cost savings of NOK 5,236 (NOK 35,830 with FDI versus NOK 41,066 with FCM). The need for phosphate testing in patients treated with FCM resulted in further cost savings with FDI (no costs with FDI versus NOK 4,470 with FCM). Total cost savings with FDI were therefore NOK 9,707. FDI also increased quality-adjusted life expectancy by 0.071 quality-adjusted life years (QALYs) driven by reduced incidence of hypophosphatemia and fewer interactions with the healthcare system.

CONCLUSIONS

FDI resulted in cost savings and improved quality-adjusted life expectancy versus FCM in patients with IDA and IBD in Norway. FDI therefore represents the economically preferable iron formulation in Norwegian patients with IBD and IDA in whom it is indicated.

摘要

目的

缺铁性贫血(IDA)是炎症性肠病(IBD)最常见的肠外后遗症之一。对于有或无活动性出血、铁吸收不良或不耐受口服铁剂的活动性炎症患者,静脉补铁通常是首选治疗方法。本研究的目的是评估在挪威IBD合并IDA患者中,去铁胺麦芽糖铁(FDI)与羧基麦芽糖铁(FCM)的成本效益。

材料与方法

采用已发表的患者水平模拟模型,从挪威国家支付方的角度评估FDI与FCM在IBD合并IDA患者中的成本效益。根据血红蛋白和体重的双变量分布以及FDI和FCM产品特性摘要中的简化铁需求表对铁需求量进行建模。患者特征和疾病相关生活质量数据来自PHOSPHARE-IBD试验。在五年时间范围内,以挪威克朗(NOK)评估成本效益。

结果

五年内,患者接受FDI的输液次数比FCM少1.64次(5.62次对7.26次),相当于每个疗程少0.41次输液。输液次数的减少节省了5236挪威克朗的成本(FDI为35830挪威克朗,FCM为41066挪威克朗)。FCM治疗患者进行磷酸盐检测的需求使得FDI进一步节省了成本(FDI无成本,FCM为4470挪威克朗)。因此,FDI总共节省了9707挪威克朗的成本。由于低磷血症发病率降低以及与医疗系统的相互作用减少,FDI还使质量调整生命预期增加了0.071个质量调整生命年(QALY)。

结论

在挪威IBD合并IDA患者中,与FCM相比,FDI节省了成本并提高了质量调整生命预期。因此,对于有适应证的挪威IBD合并IDA患者,FDI是经济上更优的铁制剂。

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