Page 86 - 《中国药房》2022年17期

·药物经济学·

渴络欣胶囊联用化学药治疗糖尿病肾病的药物经济学评价 Δ

刘 畅 ，陶立波 ，陆 灏 ，康后生 ，李 伟 ，刘 垠 ，谢雁鸣 ，崔 鑫（1.北京大学医学部卫生政策与技术
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评估中心，北京 100191；2.上海中医药大学附属曙光医院内分泌科，上海 200021；3.川北医学院附属医院内
分泌科，四川 南充 637000；4.山东中医药大学附属医院肾内科，济南 250011；5.川北医学院临床医学系，四川
南充 637100；6.中国中医科学院中医临床基础医学研究所，北京 100700）
中图分类号 R956 文献标志码 A 文章编号 1001-0408（2022）17-2124-05
DOI 10.6039/j.issn.1001-0408.2022.17.15
摘 要 目的 从全社会角度出发，评价渴络欣胶囊联用化学药治疗糖尿病肾病（DKD）的经济性。方法 采用二次文献检索、样本
医院病案数据分析、临床专家咨询等方法，构建周期为1年、时限为40年的六状态Markov模型；以质量调整生命年（QALY）为产出
指标，贴现率设为5％，并以1倍我国2020年人均国内生产总值（GDP）作为增量成本-效果比（ICER）的判断阈值，评价渴络欣胶囊
联用化学药对比单用化学药治疗DKD的经济性。结果 40年间，渴络欣胶囊联用化学药组比单用化学药组人均多花费8 644.09
元，多获得0.143 QALYs，ICER为60 460.25元/QALY，小于1倍我国2020年人均GDP（72 447元）。敏感性分析结果显示，渴络欣
胶囊年用药天数和早期DKD的健康效用值等变量对经济性分析的结果影响较大。概率敏感性分析结果则提示本研究的基线分
析结果稳健。结论 在当前价格水平下，相比单用化学药的治疗方案，渴络欣胶囊联用化学药治疗DKD更具有经济性。在决策应
用中需要注意渴络欣胶囊用量和患者健康效用值等变量的取值情况。
关键词 渴络欣胶囊；糖尿病肾病；药物经济学

Pharmacoeconomic evaluation of Keluoxin capsule combined with chemical medicine in the treatment of
diabetic kidney disease
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LIU Chang ，TAO Libo ，LU Hao ，KANG Housheng ，LI Wei ，LIU Yin ，XIE Yanming ，CUI Xin（1. Center for
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Health Policy and Technology Evaluation，Peking University Health Science Center，Beijing 100191，China；
2. Dept. of Endocrinology， Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese
Medicine，Shanghai 200021，China；3. Dept. of Endocrinology，the Affiliated Hospital of North Sichuan
Medical College，Sichuan Nanchong 637000，China；4. Dept. of Nephrology，Affiliated Hospital of Shandong
University of Traditional Chinese Medicine，Jinan 250011，China；5. Dept. of Clinical Medicine，North Sichuan
Medical College，Sichuan Nanchong 637100，China；6. Institute of Basic Research in Clinical Medicine，China
Academy of Chinese Medical Sciences，Beijing 100700，China）
ABSTRACT OBJECTIVE To evaluate the cost-effectiveness of Keluoxin capsule combined with chemical medicine in the
treatment of diabetic kidney disease（DKD）from the perspective of the whole society. METHODS Six-state Markov model with 1
year cycle and 40 years time horizon was constructed by means of secondary literature review，medical record analysis of sample
hospital and clinical expert consultation. The cost-effectiveness of Keluoxin capsule combined with chemical medicine versus
chemical medicine alone for DKD was evaluated by taking the quality-adjusted life year（QALY）as the output index，setting the
discount rate as 5％，and taking one time domestic gross domestic product（GDP）per capita in 2020 of China as the judgement
threshold of incremental cost-effectiveness ratio（ICER）. RESULTS Within 40 years，Keluoxin capsule combined with chemical
medicine group spent 8 644.09 yuan per capita more than chemical medicine alone group，and gained more 0.143 QALYs；ICER
was 60 460.25 yuan/QALY，which was less than one times GDP per capita of China in 2020 （72 447 yuan）. The results of
sensitivity analysis showed that the annual days of using Keluoxin capsule，the health utility value of DKD at early stage had a
great influence on the results of cost-effectiveness analysis. The results of probabilistic sensitivity analysis suggested that the basic
analysis results of this study were robust. CONCLUSIONS At the current price level，Keluoxin capsule combined with chemical
Δ 基金项目 国家重点研发计划中医药现代化研究重点专项 medicine is more cost-effective to treat DKD than chemical
（No.2018YFC1707400） medicine alone. The dosage of Keluoxin capsule and health
＊第一作者 硕士。研究方向：药物经济学。E-mail：2016593026pku@ utility value should be paid attention in specific decision-
bjmu.edu.cn making scenarios.
# 通信作者 研究员，博士。研究方向：卫生政策、卫生技术评估。 KEYWORDS Keluoxin capsule； diabetic kidney disease；
电话：010-82805251。E-mail：taolibo@hsc.pku.edu.cn pharmacoeconomics

·2124 · China Pharmacy 2022 Vol. 33 No. 17 中国药房 2022年第33卷第17期