中国药房2026，Vol.37Issue(16)：2131-2137,7.DOI:10.6039/j.issn.1001-0408.2026.16.09
艾拉莫德联合甲氨蝶呤用于单药治疗失败的活动性类风湿关节炎患者的成本-效用分析
Cost-utility analysis of iguratimod combined with methotrexate for active rheumatoid arthritis patients with failed monotherapy
摘要
Abstract
OBJECTIVE To evaluate the cost-utility of iguratimod combined with methotrexate in the treatment of patients with active rheumatoid arthritis(RA)who failed monotherapy with conventional synthetic disease-modifying antirheumatic drugs(csDMARDs).METHODS A cost-utility analysis was performed.A Markov model was constructed from the perspective of China's healthcare system with a cycle length of 6 months to simulate the costs and health outcomes[quality-adjusted life years(QALYs)]of iguratimod combined with methotrexate versus different combined csDMARDs regimens over a 30-year time horizon.Efficacy and safety data were synthesized from randomized controlled trials via network meta-analysis.Cost parameters were derived from the Menet Database,published literature and other sources.The discount rate was set at 4.5%,and the willingness-to-pay(WTP)threshold was twice China's per capita gross domestic product in 2025(199 330.00 yuan/QALY).One-way sensitivity analysis,probabilistic sensitivity analysis and scenario analysis were conducted to verify the robustness of the results.RESULTS Compared with methotrexate+sulfasalazine and sulfasalazine+leflunomide,iguratimod+methotrexate was a dominant regimen.Compared with methotrexate+leflunomide,the incremental cost-effectiveness ratio of iguratimod+methotrexate was 60 577.10 yuan/QALY,which was lower than the WTP threshold.Sensitivity analyses and scenario analysis confirmed favorable robustness of the above findings.CONCLUSIONS From the perspective of China's healthcare system,iguratimod+methotrexate is cost-effective for active RA patients failing csDMARD monotherapy,in comparison with methotrexate+leflunomide,methotrexate+sulfasalazine and sulfasalazine+leflunomide regimens.关键词
艾拉莫德/传统合成改善病情抗风湿药/类风湿关节炎/甲氨蝶呤/联合疗法/药物经济学/马尔可夫模型Key words
iguratimod/conventional synthetic disease-modifying antirheumatic drugs/rheumatoid arthritis/methotrexate/combination therapy/pharmacoeconomics/Markov model分类
医药卫生引用本文复制引用
龚小玲,颜建周,董心月,赖永全..艾拉莫德联合甲氨蝶呤用于单药治疗失败的活动性类风湿关节炎患者的成本-效用分析[J].中国药房,2026,37(16):2131-2137,7.基金项目
国家自然科学基金项目(No.72274217) （No.72274217）
南昌大学第一附属医院高新医院院内资助项目(No.院KYZZ202307) （No.院KYZZ202307）
