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非奈利酮联合标准方案治疗糖尿病肾病的药物经济学评价
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梁 海 ，夏茹楠，狄潘潘，赵蒙蒙，张鹏程，侯亚申，张 红，吴 炜，杨 淼（亳州市人民医院药学部，安徽 亳
州 236800）

中图分类号 R956 文献标志码 A 文章编号 1001-0408（2025）01-0086-05
DOI 10.6039/j.issn.1001-0408.2025.01.14

摘 要 目的 对非奈利酮联合标准方案治疗糖尿病肾病（DN）的经济性进行评价。方法 基于我国医疗服务提供者角度，在一项
非奈利酮治疗DN的Ⅲ期临床试验基础上，建立非奈利酮联合标准治疗方案和标准治疗方案治疗DN的Markov模型，模拟周期为
4个月，模拟时限为15年，年贴现率为5%，模拟非奈利酮联合标准治疗方案和标准治疗方案治疗DN患者终身的效果与成本；同时
进行单因素敏感性分析、概率敏感性分析，以检验结果的稳健性。结果 标准治疗方案的累计成本为 579 329.54 元，累计效用为
8.052 4质量调整生命年（QALYs）；非奈利酮联合标准治疗方案的累计成本为332 520.61元，累计效用为8.187 4 QALYs。非奈利
酮联合标准治疗方案的成本更低且效果更好。单因素敏感性分析结果显示，透析、DN3及DN4状态的效用值对增量成本-效果比
的影响较大，但未影响模型的稳健性。概率敏感性分析结果显示，非奈利酮联合标准治疗方案更具经济性的概率为100%。结论
对于DN患者，使用非奈利酮联合标准治疗方案更具有经济性，为绝对优势方案。
关键词 非奈利酮；糖尿病肾病；成本-效用；Markov模型；药物经济学

Pharmacoeconomic evaluation of finerenone combined with standard treatment regimen in the treatment of
diabetic nephropathy

LIANG Hai，XIA Runan，DI Panpan，ZHAO Mengmeng，ZHANG Pengcheng，HOU Yashen，ZHANG Hong，
WU Wei，YANG Miao（Dept. of Pharmacy， the People’s Hospital of Bozhou， Anhui Bozhou 236800， China）

ABSTRACT OBJECTIVE To evaluate the cost-effectiveness of finerenone combined with standard treatment regimen in the
treatment of diabetic nephropathy （DN）. METHODS From the perspective of healthcare service providers， a Markov model was
established to simulate the dynamic changes of each stage in DN patients who received finerenone combined with the standard
treatment regimen or the standard treatment regimen alone based on the phase Ⅲ clinical trial study of finerenone for DN. Markov
model was used to perform the cost-effectiveness of long-term effects and the costs of the two therapies with a simulation cycle of 4
months， a simulation period of 15 years and an annual discount rate of 5%. At the same time， one-way sensitivity analysis and
probability sensitivity analysis were performed， and the stability of the results was validated. RESULTS Accumulative cost of the
standard treatment regimen was 579 329.54 yuan， and the accumulative utility was 8.052 4 quality-adjusted life year （QALYs）； the
accumulative cost of finerenone combined with the standard treatment regimen was 332 520.61 yuan， and the accumulative utility
was 8.187 4 QALYs. Finerenone combined with the standard treatment regimen was more cost-effective. The results of one-way
sensitivity analysis showed that dialysis status utility value， DN stage 3 utility value and DN stage 4 utility value had a great
influence on the incremental cost-effectiveness ratio， but did not affect the robustness of the model. The results of probability
sensitivity analysis showed that finerenone combined with the standard treatment regimen was more cost-effective with 100%
probability. CONCLUSIONS For DN patients， finerenone combined with the standard treatment regimen is more cost-effective as
an absolute advantage option.
KEYWORDS finerenone； diabetic nephropathy； cost-utility； Markov model； pharmacoeconomics

糖尿病肾病（diabetic nephropathy，DN）是糖尿病患
Δ 基金项目 安徽省重点研究与开发计划项目（No.2022e0702006
6）；亳州市卫生健康科研项目（No.bzwj2023b001） 者严重的微血管并发症之一，以蛋白尿、肾小球滤过率
＊第一作者 副主任药师，硕士生导师，硕士。研究方向：药物经济 下降等进行性肾功能衰退为主要表现 。目前，我国DN
[1]
学。E-mail：lianghai_ay@163.com
患病人数为3 165万，其中2型糖尿病患者的DN发病率
# 通信作者 主任医师，硕士生导师，硕士。研究方向：药物经济
学，神经病学。E-mail：yangmiaobz66@sina.com 为 21.8% 且呈上升趋势 [2―3] 。据统计，DN 是导致终末期

· 86 · China Pharmacy 2025 Vol. 36 No. 1 中国药房 2025年第36卷第1期