中华临床免疫和变态反应杂志2024，Vol.18Issue(4)：349-357,9.DOI:10.3969/j.issn.1673-8705.2024.04.004
降尿酸治疗初期不同措施预防痛风发作的成本效果分析
Cost-effectiveness of prophylaxis on gout flares when initiating urate-lowering therapy
摘要
Abstract
Objective To evaluate the cost-effectiveness of different anti-inflammatory medications ver-sus no prophylaxis therapy to prevent gout flares when initiating urate-lowering therapy.Methods This study employed a decision tree model,utilizing data sourced from a randomized clinical trial(FORTUNE-1)and a database cohort study(IQVIATM Health Plan Claims Database).The study was completed from a healthcare system perspective,with a time horizon of 3 months.It evaluated the cost-effectiveness of three strategies:no prophylaxis,low-dose colchicine,or low-dose non-steroidal anti-inflammatory drug(NSAID,taking naproxen as an example)during the initial phase of urate-lowering therapy to prevent gout attacks.The outcomes were measured as incremental cost-effectiveness ratio(ICER)and incremental net monetary benefit(INMB).Results The base-case analysis revealed that during three months,the colchicine prophylaxis arm resulted in a cost of 55.29 yuan and 0.2480 QALYs,the NSAID prophylaxis arm was 196.96 yuan and 0.2482 QALYs,and no prophylaxis arm was 82.41 yuan and 0.2451 QALYs.Compared to no prophylaxis,the ICER of colchi-cine and NSAID prophylaxis were-9197.73 yuan per QALY(dominance)and 36 514.08 yuan per QALY,respectively;INMB were 785.35 yuan and 691.97 yuan,respectively.The scenario analysis results confirmed the robustness of the model.Univariate sensitivity analysis demonstrated that medication prophylaxis was cost-ef-fective compared with no prophylaxis.The ICER of colchicine and NSAID prophylaxis was sensitive to the cost of NSAID and the probability of diarrhea when receiving colchicine.In the probabilistic sensitivity analysis,the probability of colchicine prophylaxis,NSAID prophylaxis,and no prophylaxis being the most cost-effective op-tion was 67.6%,3.1%,and 29.3%,respectively.Conclusion At the current economic level,colchicine prophylaxis to prevent gout flares when initiating urate-lowering therapy is very cost-effective.关键词
痛风/秋水仙碱/成本-效果分析Key words
gout/colchicine/cost-effectiveness analysis引用本文复制引用
王悠扬,张楚珩,黄晓明,焦洋..降尿酸治疗初期不同措施预防痛风发作的成本效果分析[J].中华临床免疫和变态反应杂志,2024,18(4):349-357,9.基金项目
中央高水平医院临床科研业务费(2022-PUMCH-A-017,2022-PUMCH-B-045) High Level Hospital Clinical Research Funding(2022-PUMCH-A-017,2022-PUMCH-B-045) （2022-PUMCH-A-017,2022-PUMCH-B-045）
