目的 比较门冬胰岛素30和精蛋白生物合成人胰岛素30R治疗2型糖尿病的经济性,为临床用药选择、药品定价等相关决策提供参考。方法 采用二次文献研究,搜集国内外已发表的关于门冬胰岛素30和精蛋白生物合成人胰岛素30R治疗2型糖尿病的有效性的相关文献,并进行汇总、筛选,利用Revman5.2软件对所提取的有效性数据进行Meta分析,在此基础上,对门冬胰岛素30和精蛋白生物合成人胰岛素30R进行成本-效果分析,并进行敏感性分析。结果 门冬胰岛素30组和精蛋白生物合成人胰岛素30R组总成本分别为1 665.44元和1 383.86元,HbA1c分别降低2.46和1.83个单位;针对文献质量、药品价格、疗程、使用剂量及检查成本进行的敏感性分析显示这一结果稳定。结论 门冬胰岛素30治疗2型糖尿病的经济性总体上优于精蛋白生物合成人胰岛素30R,更具有临床推广价值,但还需进一步深入研究。
Abstract
OBJECTIVE To evaluate the cost-effectiveness of insulin aspart30(BIAsp 30) versus premixed human insulin 30/70 (BHI 30) in patients with type 2 diabetes (T2DM) in China so as to provide a reference for relevant decision of drug selection and drug pricing. METHODS Based on a secondary document study method and literature review both at home and abroad, a summary and screening were made on the safety and effectiveness of BIAsp 30 versus BHI 30 for the treatment among insulin-naive people with T2DM. A Meta-analysis was performed to assess the effectiveness and safety of the selected data by using software RevMan5.2. Then combine the price from the National Development and Reform Commission, National Health and Family Planning Commission to perform cost-effectiveness analysis from a social prospective. Sensitivity analysis and publication bias were conducted. RESULTS Treatment with BIAsp 30 is associated with more cost than BHI 30 (￥1 665.44 vs ￥1 383.86),and the effectiveness data of BIAsp 30 was higher than BHI 30 (2.46 vs 1.83). Compared with BHI 30, BIAsp 30 is more efficient in pharmacoeconomic cost-effectiveness analysis, and sensitivity analyses demonstrated robustness of the RESULTS. CONCLUSION BIAsp 30 is better than BHI 30 in terms of the economy, but it still needs further research.
关键词
2型糖尿病 /
门冬胰岛素30 /
精蛋白生物合成人胰岛素30R /
Meta分析 /
成本-效果分析
{{custom_keyword}} /
Key words
type 2 diabetes /
insulin aspart 30 /
premixed human insulin 30/70 /
meta-analysis /
cost-effectiveness
{{custom_keyword}} /
中图分类号：
R956
{{custom_clc.code}}
({{custom_clc.text}})
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] International Diabetes Federation, IDF Diabetes Atlas-7th Edition[EB/OL]. 2015 [2015-12-01]. Http://www. diabetesatlas. org/across-the-globe. html.
[2] Chinese Diabetes Society. Guidelines for prevention and treatment of type 2 diabetes in China (2013 Edition)[J]. Chin J Diabet(中国糖尿病杂志), 2014, 22(8):2-42.
[3] Chinese Society of Endocrinology. Expert consensus ofthe clinical insulin application for Chinese adult with type 2 diabetes [J]. Chin J Endocrinol Metabol(中华内分泌代谢杂志), 2013, 29(1):1-6.
[4] MENET. Diabetes drug market research report for 2013[EB/OL]. 2015 [2015-12-01]. http://www. menet. com. cn/vip/article/article2. aspx?id=100224.
[5] ZHU L, LI S, FU X, et al. The clinical study to treatment of newly diagnosed type 2 diabetes with BIAsp 30 and BHI 30[J]. Sichuan Med J(四川医学), 2010, 31(7):917-918.
[6] SAKURABA H, MIZUKAMI H, YAGIHASHI N, et al. Reduced beta-cell mass and expression of oxidative stress-related DNA damage in the islet of Japanese Type Ⅱ diabetic patients[J]. Diabetologia, 2002, 45(1):85-96.
[7] QIAN L, XU L, FU X, et al. Early insulin secretion failure leads to diabetes in Chinese subjects with impaired glucose regulation[J]. Diabetes Metabolism Res & Rev, 2009, 25(2):144-149.
[8] LIU G, HU S, WU J. China guidelines for pharmacoeconomic evaluations(2011 edition)[J]. China J Pharm Economics(中国药物经济学), 2011,3:6-9, 11-48.
[9] SUN L. Pharmaceutical Economics[M]. Second Edition. Beijing: China Medical Science Press, 2010.
[10] Chinese Society of Endocrinology. Expert consensus of HbA1C control target for Chinese adult with type 2 diabetes[J]. Chin J Endocrinol Metabol(中国医学前沿杂志), 2011, 27(5):371-374.
[11] LI W. Clinical application guide of blood glucose monitoring in China (Edition 2015)[J]. Chin J Diabetes(中国糖尿病杂志), 2015, 7(10):23-25.
[12] ZHENG Y, ?STERLE A, LIU X, et al. PDB22 the direct medical cost for diabetes mellitus (DM) related complications in China[J]. Value Health, 2012, 15(7):662-663.
[13] STRATTON I M, ADLER A I, NEIL H A, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study [J]. BM J Clinic Res, 2000, 321(7258):405-412.
[14] ROSENQVIST U. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group [J]. New England J Med, 1993, 329(14):977-986.
[15] LEITER L A, YALE J F, CHIASSON J L, et al. Assessment of theimpact of fear of hypoglycemic episodes on glycemic andhypoglycemia management[J]. Can J Diabetes, 2005, 29(3):186-192.
{{custom_fnGroup.title_cn}}
脚注
{{custom_fn.content}}
PDF(823 KB)
