利妥昔单抗对比环磷酰胺/硫唑嘌呤治疗ANCA相关性血管炎的成本-效果分析

单慧亭; 王钰博; 徐跃洳; 潘慧敏; 吉鹏; 陈迹; 杨建华

引用本文:	单慧亭,王钰博,徐跃洳,潘慧敏,吉鹏,陈迹,杨建华.利妥昔单抗对比环磷酰胺/硫唑嘌呤治疗ANCA相关性血管炎的成本-效果分析[J].中国现代应用药学,2025,42(23):163-169.
	shan huiting,wang yubo,xu yueru,pan huimin,ji peng,chen ji,yang jianhua.Cost-effectiveness analysis of rituximab and cyclophosphamide/azathioprine in the treatment of ANCA-associated vasculitis[J].Chin J Mod Appl Pharm(中国现代应用药学),2025,42(23):163-169.

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利妥昔单抗对比环磷酰胺/硫唑嘌呤治疗ANCA相关性血管炎的成本-效果分析
单慧亭¹, 王钰博¹, 徐跃洳², 潘慧敏¹, 吉鹏³, 陈迹¹, 杨建华¹
1.新疆医科大学第一附属医院药学部;2.新疆医科大学药学院;3.新疆医科大学第一附属医院风湿免疫科

摘要:

目的从我国卫生体系角度评价利妥昔单抗(RTX)对比环磷酰胺(CYC)/硫唑嘌呤(AZA)治疗抗中性粒细胞胞浆抗体相关性血管炎(antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis,AAV)的经济性。方法? 基于两项随机对照试验(RCT)研究结果,建立马尔可夫模型进行成本-效果分析,循环周期为6个月,模拟时限为患者终身,贴现率为5%。以增量成本-效果比(ICER)为指标评价经济性,并对结果进行敏感性分析。结果? 成本-效果分析结果显示,利妥昔单抗对比环磷酰胺/硫唑嘌呤的ICER为美元/QALY,低于2022年我国3倍人均 GDP。单因素敏感性分析结果显示对ICER影响最大的是利妥昔单抗的价格、贴现率、疾病活动状态效用值；概率敏感性分析显示,当WTP阈值为3倍GDP时,利妥昔单抗对于环磷酰胺/硫唑嘌呤具有成本-效果。结论? 在诱导及维持治疗ANCA相关性血管炎方面,相比环磷酰胺/硫唑嘌呤,利妥昔单抗更具成本-效果性。

关键词: 利妥昔单抗环磷酰胺硫唑嘌呤马尔可夫模型成本-效果

DOI：

分类号:R956

基金项目:创新研究群体科学基金

Cost-effectiveness analysis of rituximab and cyclophosphamide/azathioprine in the treatment of ANCA-associated vasculitis

shan huiting¹, wang yubo¹, xu yueru², pan huimin¹, ji peng³, chen ji¹, yang jianhua¹

1.The First Affiliated Hospital of Xinjiang Medical University, a.Pharmaceutical Department;2.College of Pharmacy, Xinjiang Medical University;3.The First Affiliated Hospital of Xinjiang Medical University,Department of Rheumatology and Immunology

Abstract:

ABSTRACT：OBJECTIVE To evaluate the economics of rituximab（RTX） versus cyclophosphamide（CYC）/azathioprine（RTX）for the treatment of ANCA-associated vasculitis from the Chinese healthcare system.METHODS Based on the results of two randomised controlled trials（RCT）,a Markov model was developed for cost-effectiveness analysis, with a cycle of 6 months, a simulation timeframe of patients' lifetime, and a discount rate of 5%. The incremental cost-effectiveness ratio (ICER) was used as an indicator to evaluate the economics, and the results were analyzed for sensitivity.RESULTS The results of the cost-effectiveness analysis showed that the ICER of rituximab versus cyclophosphamide/azathioprine was USD/QALY, which was lower than 3 times the per capita GDP of China in 2022.The results of the one-factor sensitivity analysis showed that the most influential factors on the ICER were the price of rituximab, discount rate, and utility value of the disease activity status; and the probabilistic sensitivity analysis showed that, when the threshold value of the WTP was 3 times the GDP, the rituximab had a cost-effectiveness for cyclophosphamide/azathioprine.Conclusion In Induction and Maintenance Treatment of ANCA-Associated Vasculitis, compared with Cyclophosphamide/Azathioprine,Rituximab is more cost-effectiveness.

Key words: rituximab cyclophosphamide azathioprine Markov model cost-effectiveness