中国药房2025，Vol.36Issue(9)：1087-1092,6.DOI:10.6039/j.issn.1001-0408.2025.09.12
司美格鲁肽对比卡格列净治疗二甲双胍控制不佳的2型糖尿病患者的成本-效用分析
Cost-utility analysis of semaglutide versus canagliflozin in patients with type 2 diabetes poorly controlled with metformin
摘要
Abstract
OBJECTIVE To evaluate the long-term cost-effectiveness of canagliflozin or semaglutide in patients with type 2 diabetes mellitus(T2DM)poorly controlled with metformin.METHODS Based on the perspective of China's health system,a Markov model was used to calculate the long-term costs and utilities of canagliflozin or semaglutide combined with metformin for T2DM patients in China for 30 years based on the data from SUSTAIN 8 study.The incremental cost-effectiveness ratio(ICER)and incremental net monetary benefit(INMB)were calculated using one time the 2024 per capita gross domestic product(GDP)as the willingness-to-pay(WTP)threshold.One-way sensitivity analysis,probability sensitivity analysis and scenario analysis were conducted to confirm the stability of the conclusions.RESULTS Compared with canagliflozin+metformin,ICER of semaglutide combined with metformin was 260 485.67 yuan/quality-adjusted life year(QALY),which was higher than the WTP threshold set in this study(95 749 yuan/QALY),and the corresponding INMB was-61 576.24 yuan,indicating that the canagliflozin+metformin regimen was more cost-effective.The cost of diabetes without complications treatment in the semaglutide+metformin group had the greatest influence on INMB,but changes in parameters within the selected range did not drive decision reversal.With the increasing of WTP threshold,the economic acceptability of semaglutide+metformin regimen increased.Under the current WTP threshold,the annual cost of semaglutide should be reduced by 42.95%to make the semaglutide+metformin regimen more cost-effective.CONCLUSIONS From the perspective of China's health system,canagliflozin+metformin is more cost-effective than semaglutide+metformin for T2DM patients with poor glycemic control with metformin alone.关键词
司美格鲁肽/卡格列净/二甲双胍/2型糖尿病/血糖控制不佳/Markov模型/药物经济学/队列模拟Key words
semaglutide/canagliflozin/metformin/type 2 diabetes mellitus/poor glycemic control/Markov model/pharmacoeconomics/cohort simulation分类
医药卫生引用本文复制引用
徐跃洳,王钰博,潘慧敏,单慧亭,陈迹,杨建华..司美格鲁肽对比卡格列净治疗二甲双胍控制不佳的2型糖尿病患者的成本-效用分析[J].中国药房,2025,36(9):1087-1092,6.基金项目
创新药物上市后临床研究科研专项(No.WKZX2023CX210008) （No.WKZX2023CX210008）
新疆维吾尔自治区药品临床综合评价项目(No.XJWJYZ202403) （No.XJWJYZ202403）
