| 泊沙康唑对比伏立康唑经验治疗或诊断驱动治疗免疫功能低下患者侵袭性霉菌病的成本-效果分析 |
| 投稿时间：2024-01-22 修订日期：2024-06-29 点此下载全文 |
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| 基金项目:上海市临床重点专科项目(shslczdzk06504) |
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| 中文摘要:目的：从中国卫生体系角度评估泊沙康唑对比伏立康唑经验治疗或诊断驱动治疗免疫功能低下患者侵袭性霉菌病（IMD）的经济性。方法：基于一项III期临床试验和其他公开可用的数据建立决策树模型，评价泊沙康唑相对于伏立康唑所产生的增量成本-效果比（ICER），并对结果进行单因素敏感性分析、概率敏感性分析以及情境分析。结果：基础分析结果显示，在3倍我国人均GDP的意愿支付值（WTP）下，泊沙康唑比伏立康唑多获得0.0327个质量调整生命年（QALYs）且少花费1 711.24元，具有绝对优势。敏感性分析结果显示，伏立康唑、泊沙康唑的费用对ICER影响较大；在不同的WTP下，泊沙康唑经济性优势的概率始终大于伏立康唑。情境分析显示，毛霉的感染率并未影响结果。但如果伏立康唑一定程度降价后，将显示出成本-效果优势。结论：相比伏立康唑，使用泊沙康唑经验治疗或诊断驱动治疗免疫功能低下患者IMD是一种兼具有效性和经济性的选择。 |
| 中文关键词:泊沙康唑 伏立康唑 侵袭性霉菌病 成果-效果分析 决策树模型 |
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| Cost-effectiveness analysis of posaconazole versus voriconazole in the empiric or diagnostic-driven treatment of invasive mould diseases in immunocompromised patients |
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| Abstract:Objective To evaluate the cost-effectiveness of posaconazole compared to voriconazole in the empiric or diagnostic-driven treatment of invasive mould diseases (IMD) in immunocompromised patients from the perspective of Chinese health system. Methods A decision tree model was constructed based on a phase III clinical trial and other publicly available data to evaluate the incremental cost-effectiveness ratio (ICER) of posaconazole versus voriconazole. One-way sensitivity analysis, probability sensitivity analysis, and scenario analysis were conducted. Results The results of base-case analysis indicated that, at a willingness-to-pay (WTP) threshold of 3 times Chinese GDP per capita, posaconazole gained 0.0327 quality-adjusted life years (QALYs) with the cost savings of CNY 1,711.24, demonstrating a clear cost-effectiveness advantage. Sensitivity analysis revealed that the cost of voriconazole and posaconazole significantly influenced the ICER. Under different WTP thresholds, posaconazole consistently maintained its economic advantage over voriconazole. Scenario analysis showed that the incidence of mucormycosis did not impact the results, but a price reduction in voriconazole could change result. Conclusion In the empiric or diagnostic-driven treatment of IMD in immunocompromised patients, posaconazole was both an effective and economically viable choice when compared to voriconazole. |
| keywords:posaconazole voriconazole invasive mould diseases cost-effectiveness analyses decision-tree model |
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