Page 98 - 2020年19期

·药物经济学·

2型糖尿病治疗药物经济学评价模型的分析研究 Δ

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刘海娇 ，王雅洁 ，吴玉霞 ，刘朝一 ，刘西涛 ，徐 伟 （1.中国药科大学国际医药商学院，南京 211198；2.广
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州医科大学药学院，广州 511436；3.广州医科大学附属第三医院药学部，广州 510150）
中图分类号 R956 文献标志码 A 文章编号 1001-0408（2020）19-2392-07
DOI 10.6039/j.issn.1001-0408.2020.19.16
摘 要 目的：分析近5年2型糖尿病（T2DM）治疗药物经济学评价研究中涉及模型的基本特征及其应用情况，为T2DM药物经
济学评价模型的选择和完善提供参考。方法：计算机检索PubMed、Embase、中国知网、万方数据库、维普网等数据库中2015年1
月1日－2019年12月31日公开发表的T2DM治疗药物的经济学评价文献，从模型基本结构、治疗方案设定、短期治疗效果、并发
症模拟、模型有效性验证、应用频次等方面对纳入模型进行分析。结果：共纳入81篇文献，涉及14个模型，如CORE模型、Cardiff
模型、ECHO模型等；模型多以第三方付费者角度，采用马尔可夫或微观马尔可夫模拟方法测算患者终身的健康产出和成本；7个
模型可模拟设定2～4个治疗方案；模型中分析的短期治疗效果主要包糖尿病并发症相关的危险因素（如糖化血红蛋白水平、体质
量等）和用药不良反应情况；多数模型采用中间指标模拟并发症发生情况，涵盖的并发症数量介于3～15个之间；模型有效性的效
度包括表面效度、内部效度、外部效度等；14 个模型中，近 5 年应用频次较多的模型主要为经过有效性验证的长期模型，其中
CORE模型应用次数（38/81，46.91％）最多、Cardiff模型（12/81，14.81％）次之。结论：14个模型的基本结构类似，模型差异主要体
现在治疗方案设置、考量的短期治疗效果、并发症数量及其模拟方法等3个方面。现有证据下较理想的模型选择为CORE模型和
Cardiff模型。
关键词 2型糖尿病；药物经济学；模型

Analysis Study of Pharmacoeconomic Evaluation Model of Therapy for Type 2 Diabetes Mellitus
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LIU Haijiao ，WANG Yajie ，WU Yuxia ，LIU Chaoyi ，LIU Xitao 2，3 ，XU Wei （1. School of International
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Pharmaceutical Business， China Pharmaceutical University， Nanjing 211198， China； 2. School of
Pharmaceutical Sciences，Guangzhou Medical University，Guangzhou 511436，China；3. Dept. of Pharmacy，
the Third Affiliated Hospital of Guangzhou Medical University，Guangzhou 510150，China）
ABSTRACT OBJECTIVE：To analyze the general characteristics and application of the models used in the pharmacoeconomic
evaluation of type 2 diabetes mellitus（T2DM）therapy during the past 5 years，and to provide reference for the selection and
improvement of T2DM pharmacoeconomic model. METHODS：Retrieved from PubMed，Embase，CNKI，Wanfang database and
VIP during Jan. 1st，2015 to Dec. 31st，2019，pharmacoeconomic evaluation literatures about T2DM therapy were collected；the
included model was analyzed in respects of general structure，therapy plan establishment， short-term therapeutic efficacy，
complication simulation，model effectiveness validation，application frequency. RESULTS：A total of 81 literatures were included，
involving 14 models，such as CORE model，Cardiff model，ECHO model，etc. Mostly，Markov or micro Markov simulation
method were adopted to measure the patient’s lifetime health outcome and cost mostly from the point of view of third-party payer.
Seven models could simulate 2-4 therapy plans；short-term efficacy mainly included risk factors of diabetic complications（such as
glycosylated hemoglobin level and body mass）and adverse drug reactions. Most models used intermediate indexes to simulate the
occurrence of complications，and the number of complications ranged from 3 to 15；the validity of model effectiveness included
surface validity，internal validity and external validity，etc. Among 14 models，the most frequently used models in the past 5 years
were long-term models that had been validated，among which CORE model had the most application times（38/81，46.91％），
followed by Cardiff model （12/81，14.81％）. CONCLUSIONS：The 14 models have similar structure. The differences of the
Δ 基金项目：国家医疗保障局委托课题——“我国药品与医用耗 models are mainly reflected in 3 aspects as therapy plan
材的医保支付管理研究” setting， considered short-term efficacy， the number of
＊硕士研究生。研究方向：医疗保险、药物政策、药物经济学。电 complication and simulation method. CORE model and Cardiff
话：025-86185036。E-mail：15549299579@163.com model are ideally choose based on available evidences.
# 通信作者：教授，博士。研究方向：医疗保险与国家药物政策。 KEYWORDS Type 2 diabetes；Pharmacoeconomics；Model
电话：025-86185036。E-mail：xuwei@cpu.edu.cn

·2392 · China Pharmacy 2020 Vol. 31 No. 19 中国药房 2020年第31卷第19期