国产和进口甲巯咪唑在甲状腺功能亢进症治疗中成本―效果评价.docVIP

国产和进口甲巯咪唑在甲状腺功能亢进症治疗中成本―效果评价 　　[摘要] 目的 开展对国产和进口甲巯咪唑在临床治疗甲状腺功能亢进症患者的药物经济学研究，为临床用药决策提供依据。 方法 采用回顾性研究筛选甲状腺功能亢进症患者，建立马尔可夫（Markov）模型对接受国产和进口甲巯咪唑药物治疗的患者进行模拟，并参考相关随机对照试验研究成果以及中外公开发表的文献。以不同治疗方案的费用、质量调整生命年（QALYs）作为评价指标。 结果 2年国产组和进口组甲巯咪唑的效果值QALYs均为1.24年，国产组成本为2680.86元，比进口组减少115.00元，成本-效果比为4516.50元/QALY。 结论 本研究首次尝试应用Markov模型评价国产和进口甲巯咪唑治疗甲状腺功能亢进症中的成本和效果。2年内国产和进口甲巯咪唑治疗方案疗效相当，无显著差异，但国产甲巯咪唑组的成本更低，为治疗优势方案，更具有成本-效果性。 　　[关键词] 甲状腺功能亢进症；甲巯咪唑；Markov模型；成本-效果分析；药物经济学 　　[中图分类号] R363 [文献标识码] A [文章编号] 1673-7210（2016）03（c）-0160-05 　　[Abstract] Objective To develop cost-effectiveness analysis for domestic and imported Methimazole in hyperthyroidism patients， in order to provide evidence-based reference for the clinical therapeutic regimen. Methods Patients with hyperthyroidism were analyzed retrospectively. Markov model was constructed to simulate development of healthy status of hyperthyroidism patients with domestic and imported Methimazole treatment. Randomized controlled trials （RCT） results and literature published at home and abroad were selected for reference. The costs and QALYs were considered as the estimated index in the two treatment protocols. Results 2-year cycle results showed that patients in domestic and imported Methimazole group were all 1.24 QALYs respectively. Cost of patients receiving domestic Methimazole was 2680.86 yuan， which was 115.00 yuan less than that of import， and cost-effectiveness value was 4510.56 yuan/QALY. Conclusion It is the first time to establish the Markov model to evaluate the domestic and imported Methimazole in hyperthyroidism patients. There is no significant difference in curative effects between domestic and imported groups in 2 years. However， the cost of domestic Methimazole is lower than that of imported Methimazole. Its the advantage treatment protocols， has better cost-effectiveness. 　　[Key words] Hyperthyroidism； Methimazole； Markov model； Cost-effectiveness； Drug economics 　　甲状腺功能亢进症系指多种病因引起的甲状腺高功能状态，产生过量甲状腺激素而导致的临床综合征[1]，其中，Graves