中国药房2025，Vol.36Issue(18)：2285-2290,6.DOI:10.6039/j.issn.1001-0408.2025.18.12
达格列净与恩格列净治疗2型糖尿病肾病的药物经济学评价
Pharmacoeconomic evaluation of dapagliflozin and empagliflozin in the treatment of type 2 diabetic kidney disease
摘要
Abstract
OBJECTIVE To evaluate the cost-effectiveness of dapagliflozin and empagliflozin in the treatment of type 2 diabetic kidney disease from the perspective of healthcare system in China.METHODS Based on the data from the two multicenter clinical trials,DECLARE-TIMI 58 and EMPA-REG OUTCOME,a Markov model was constructed according to the urinary albumin-to-creatinine ratio(UACR)of the patients with type 2 diabetic kidney disease with a cycle of 1 year,simulating until 99%of patients died.The model outputs were total costs and quality-adjusted life year(QALY).The cost-effectiveness of the two treatment regimens was assessed by comparing their incremental cost-effectiveness ratio(ICER)and the willingness-to-pay threshold(WTP,set at three times China's 2023 per capita gross domestic product,i.e.,268 074 yuan/QALY).Additionally,oneway sensitivity analysis and probabilistic sensitivity analysis were performed to test the robustness of the base analysis results.RESULTS Compared with dapagliflozin,the ICER for empagliflozin regimen was 44 334.82 yuan/QALY,which was below the WTP,indicating its cost-effectiveness.The results of the oneway sensitivity analysis indicated that the incidence of non-fatal myocardial infarction in both groups and the utility values associated with the microalbuminuria state had the most significant impact on the outcomes,but did not change the base-case conclusion.The probabilistic sensitivity analysis indicated that the results of the base-case analysis were robust.CONCLUSIONS With a WTP of three times China's per capita gross domestic product in 2023,empagliflozin is more cost-effective than dapagliflozin in treating type 2 diabetic kidney disease.关键词
达格列净/恩格列净/成本-效用/Markov模型/2型糖尿病肾病Key words
dapagliflozin/empagliflozin/cost-utility/Markov model/type 2 diabetic kidney disease分类
医药卫生引用本文复制引用
杨旭,赵一凡,李婉婷,刘永军..达格列净与恩格列净治疗2型糖尿病肾病的药物经济学评价[J].中国药房,2025,36(18):2285-2290,6.基金项目
2023年度高校哲学社会科学研究一般项目(No.2023SJYB0076) （No.2023SJYB0076）
