Huang Yueyang, Yuan Hongmei, Huang Zhe
School of Business Administration, Shenyang Pharmaceutical University, Shenyang, China.
Front Med (Lausanne). 2025 May 13;12:1568709. doi: 10.3389/fmed.2025.1568709. eCollection 2025.
Gaucher disease (GD) is an autosomal recessive disorder with a wide range of clinical symptoms that cause abnormal function of parenchymal organs such as liver and spleen in patients. Enzyme replacement therapy, represented by imiglucerase, is a common approach for GD treatment. However, limited efficacy and high cost are important factors restricting its use. Ambroxol has gradually attracted attention due to its ease of administration, safety, and efficacy. However, there is no pharmacoeconomic evaluation of ambroxol for the treatment of GD in China. The cost-effectiveness profile of ambroxol combined with imiglucerase therapy for the treatment of GD, as opposed to imiglucerase monotherapy, needs to be investigated.
This study aimed to analyze the cost-effectiveness of ambroxol for GD in China from the perspective of the Chinese healthcare system.
We constructed an eight-state Markov model based on the disease characteristics of GD. The Markov cycle was 1 month. The time horizon was 6 years. The willingness-to-pay threshold was chosen to be 1-3 times the gross national product (GDP) per capita. The incremental cost-effectiveness ratio (ICER) was calculated from the base-case analysis, and one-way sensitivity analyses and probabilistic sensitivity analyses were performed.
The ICER value was ¥223,726.70, which was between 1 and 3 times GDP per capita. Sensitivity analysis showed that the cost of imiglucerase had a significant effect on ICER as well as demonstrating the stability of the results.
Ambroxol combination therapy is a cost-effective regimen compared with imiglucerase monotherapy.
戈谢病(GD)是一种常染色体隐性疾病,具有广泛的临床症状,可导致患者肝脏和脾脏等实质器官功能异常。以伊米苷酶为代表的酶替代疗法是治疗戈谢病的常用方法。然而,疗效有限和成本高昂是限制其应用的重要因素。氨溴索因其给药方便、安全性高和疗效显著而逐渐受到关注。然而,在中国,尚无关于氨溴索治疗戈谢病的药物经济学评价。与伊米苷酶单药治疗相比,氨溴索联合伊米苷酶治疗戈谢病的成本效益情况有待研究。
本研究旨在从中国医疗保健系统的角度分析氨溴索治疗戈谢病的成本效益。
我们基于戈谢病的疾病特征构建了一个八状态马尔可夫模型。马尔可夫周期为1个月。时间跨度为6年。支付意愿阈值选择为人均国民生产总值(GDP)的1至3倍。从基础案例分析中计算增量成本效益比(ICER),并进行单向敏感性分析和概率敏感性分析。
ICER值为223,726.70元,介于人均GDP的1至3倍之间。敏感性分析表明,伊米苷酶的成本对ICER有显著影响,同时也证明了结果的稳定性。
与伊米苷酶单药治疗相比,氨溴索联合治疗是一种具有成本效益的治疗方案。