治疗日本成年特应性皮炎的 1%地拉米司特成本效益研究

IF 3.5 3区 医学 Q1 DERMATOLOGY Dermatology and Therapy Pub Date : 2024-11-01 DOI:10.1007/s13555-024-01300-2
Takeshi Nakahara, Shinichi Noto, Miyuki Matsukawa, Hiroe Takeda, Yilong Zhang, Tomohiro Kondo
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引用次数: 0

摘要

简介:在日本,地拉米司特已被证明是治疗特应性皮炎(AD)的有效疗法,但其成本效益仍然未知。因此,本研究旨在从日本公共医疗保健的角度出发,确定地拉米司特 1%与德尔戈西替尼 0.5%在日本中重度特应性皮炎成年患者中的成本效益,以及地拉米司特 1%与安慰剂在日本所有严重程度特应性皮炎成年患者中的成本效益:分析采用了日本公共医疗保健角度的成本效益模型。该模型有四种健康状态("无"、"轻度"、"中度 "和 "重度"),根据湿疹面积和严重程度指数评分进行定义。分析的时间跨度为 1 年。由于分析时间较短,因此未采用贴现率。模型中采用了之前通过锚定匹配调整间接比较法估算出的患者比例。模型中还进一步加入了文献数据。模型的主要结果是质量调整生命年(QALY)、成本和结果,包括增量成本效益比。所有价格均以日元表示,价格水平为 2018 年 4 月至 2019 年 3 月。为评估结果的稳健性,进行了单向敏感性分析和概率敏感性分析(PSA):在基本病例中,1%地拉米司特与0.5%德尔戈西替尼和安慰剂相比,成本效益分别为827,054日元/QALY和1,518,657日元/QALY。PSA 显示,与德尔戈西替尼 0.5% 和安慰剂相比,地拉米司特 1%的成本效益分别有 66.6% 和 99.6% 的概率低于 500 万日元/QALY 临界值:结果表明,从日本公共医疗保健的角度来看,在日本中重度AD成年患者中,与德尔戈西替尼0.5%相比,地拉米司特1%是一种更具成本效益的治疗方案;在所有严重程度AD成年患者中,与安慰剂相比,地拉米司特1%是一种更具成本效益的治疗方案。
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Cost-Effectiveness Study of Difamilast 1% for the Treatment of Atopic Dermatitis in Adult Japanese Patients.

Introduction: Difamilast has proven to be an effective treatment for the treatment of atopic dermatitis (AD) in Japan, but its cost-effectiveness remains unknown. Therefore, the objective of the current study was to determine the cost-effectiveness of difamilast 1% compared with delgocitinib 0.5% in Japanese adult patients with moderate-to-severe AD and compared with placebo in Japanese adult patients with all-severity AD from a Japanese public health-care perspective.

Methods: The analysis was conducted using a cost-effectiveness model from the Japanese public health-care perspective. This model had four health states ("clear," "mild," "moderate," and "severe") defined according to the Eczema Area and Severity Index score. The time horizon of the analysis was 1 year. Because the analysis period was short, no discount rate was applied. The proportions of patients previously estimated by the anchored matching-adjusted indirect comparison were implemented in the model. The model was further populated with data from the literature. The main model outcomes were quality-adjusted life-years (QALY), costs, and outcomes, including the incremental cost-effectiveness ratio. All prices were stated in JPY at the price level from 2018 April to 2019 March. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were performed to assess the robustness of the results.

Results: In the base case, the cost-effectiveness of difamilast 1% compared with delgocitinib 0.5% and placebo was JPY 827,054/QALY and JPY 1,518,657/QALY, respectively. The PSA showed that the cost-effectiveness of difamilast 1% compared with delgocitinib 0.5% and placebo had a 66.6% and 99.6% probability of being below the JPY 5 million/QALY threshold, respectively.

Conclusion: The results suggest that difamilast 1% is a more cost-effective treatment option compared with delgocitinib 0.5% in Japanese adult patients with moderate-to-severe AD and compared with placebo in adult patients with all-severity AD from a Japanese public health-care perspective.

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来源期刊
Dermatology and Therapy
Dermatology and Therapy Medicine-Dermatology
CiteScore
6.00
自引率
8.80%
发文量
187
审稿时长
6 weeks
期刊介绍: Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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