基于Markov模型的丁苯酞序贯治疗再灌注后缺血性脑卒中成本-效用分析

    Cost-effectiveness of Analysis Sequential Therapy with Butylphthalide in Treatment of Ischemic Stroke After Reperfusion Based on Markov Model

    • 摘要:
      目的  评价丁苯酞序贯治疗再灌注后急性缺血性脑卒中患者的经济性。
      方法 从中国卫生体系角度出发,基于1项随机对照临床试验研究结果,构建Markov模型,模拟无显著残疾、显著残疾、复发及死亡的动态变化。试验组为再灌注联合丁苯酞序贯治疗,对照组为再灌注联合安慰剂治疗。运用TreeAge Pro 2020软件构建药物经济学模型并模拟分析。
      结果 模型模拟30周期后,试验组的成本和产出分别为294 039.09元和4.86质量调整生命年(quality adjusted life years,QALYs);对照组的成本和产出分别为269 042.84元和4.66 QALYs。相比对照组,试验组的增量成本-效用为126 816.55元·QALY−1,小于意愿支付阈值。敏感性分析结果显示该经济学评价结果稳定。
      结论 对于再灌注治疗的急性缺血性脑卒中患者而言,相比于安慰剂,丁苯酞序贯治疗为成本-效用较好的方案。

       

      Abstract:
      OBJECTIVE  To evaluate the economic of sequential therapy with butylphthalide for patients with acute ischemic stroke after reperfusion.
      METHODS  From the perspective of the health system, based on the results of a randomized controlled clinical trial, Markov model was constructed to simulate the dynamic changes of no significant disability, significant disability, recurrence, and death. The experimental group was treated with reperfusion combined with sequential butylphthalide, while the control group was treated with reperfusion combined with placebo. Utilize TreeAge Pro 2020 software to construct pharmacoeconomic models and conduct simulation analyses.
      RESULTS  After 30 cycles of model simulation, the results showed that the cost and output of the experimental group were 294039.09 yuan and 4.86 quality adjusted life years(QALYs); the results showed that the cost and output of the control group were 269042.84 yuan and 4.66 QALYs. Compared with the control group, the incremental cost effectiveness of the experimental group was 126816.55 yuan·QALY−1, which was less than the willingness to pay threshold. The sensitivity analysis supported the robustness of the results.
      CONCLUSION  For acute ischemic stroke patients with vascular recanalization, compared to placebo, sequential treatment with butylphthalide is a pharmacoeconomic advantageous treatment.

       

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