长效lanreotide在俄罗斯联邦卫生保健系统条件下用于肢端肥大症治疗的比较药物经济学分析

I. Krysanov, E. Makarova, V. Ermakova
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摘要

本研究的目的是对长效皮下lanreotide凝胶与替代药物治疗肢端肥大症进行综合药物经济学评价。材料和方法。在文献资料的基础上,建立1年展望治疗模型,进行药物经济学成本-效果分析(CEA)和模型参数变化敏感性分析。计算每年治疗过程的直接医疗费用。药品成本数据取自国家药品注册中心的边际价格登记册。根据俄罗斯垂体-下丘脑肿瘤区域的统一登记,与长效奥曲肽相比,使用lanreotide(一种长效皮下给药凝胶)治疗肢端肥大症患者的缓解率为51%对24%。在奥曲肽治疗的第一年,总药物治疗费用低于lanreotide(225,496.07卢布对574,451.84卢布)。根据1例获得缓解的病例的成本-效果分析结果显示,使用lanreotide优于长效奥曲肽(1,251,870.56卢布对1,431,005.31卢布)。敏感性分析表明,该模型对lanreotide价格的上升(高达+18%)、奥曲肽价格的下降(高达-22%)、经蝶窦腺瘤切除术价格的上升(高达+59%)和lanreotide缓解率的下降(高达-12%)具有稳定性。虽然治疗成本分析显示长效奥曲肽治疗的年总成本低于lanreotide,但每次缓解的成本-效果比计算显示lanreotide优于长效奥曲肽。
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COMPARATIVE PHARMACOECONOMIC ANALYSIS OF LONG-ACTING LANREOTIDE USED IN ACROMEGALY THERAPY WITHIN CONDITIONS OF THE RUSSIAN FEDERATION HEALTH CARE SYSTEM
The aim of this study is to conduct a comprehensive pharmacoeconomic evaluation of the use of long-acting subcutaneous lanreotide gel compared to alternative drugs, for the treatment of acromegaly.Materials and methods. Based on the literature data, a treatment model with a 1-year outlook was developed, a cost-effectiveness analysis (CEA) in pharmacoeconomics and a sensitivity analysis of changes in the model parameters were carried out. Direct medical costs for the annual therapy course were calculated. The data on the medicines costs were taken from the register of marginal prices of the State Register of Medicines.Results. According to the unified Russian registry of the pituitary-hypothalamic tumors area, the achievement of remission in the acromegaly patients using lanreotide, a long-acting gel for a subcutaneous administration, compared to the long-acting octreotide, is 51% vs 24%. During the first year of treatment with octreotide, the total pharmacotherapy costs were lower than with lanreotide (RUB 225,496.07 vs RUB 574,451.84). According to the results of the cost-effectiveness analysis for one achieved case of remission, the advantage of using lanreotide over long-acting octreotide was revealed (RUB 1,251,870.56 versus RUB 1,431,005.31). The sensitivity analysis demonstrated the model’s stability to increases in the lanreotide price (up to +18%), decreases in the octreotide prices (up to –22%), increases in the transsphenoidal adenomectomy prices (up to +59%), and decreased lanreotide remission rates (up to –12%).Conclusion. Although the treatment costs analysis showed lower total per year costs of the treatment with long-acting octreotide compared to lanreotide, the calculation of the cost-effectiveness ratio per remission showed that lanreotide had been superior to long-acting octreotide.
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