基于Markov模型评价罗沙司他对比重组人促红素治疗非透析患者肾性贫血的经济学研究

目的：从医疗体系角度，比较罗沙司他与重组人促红素治疗非透析依赖性慢性肾病（NDD-CKD）患者贫血的经济性，为肾性贫血的治疗提供参考依据。方法：使用Markov模型评价罗沙司他与重组人促红素的成本与效用，得到患者的治疗成本和质量调整生命年（QALY）。临床参数来自DOLOMITES研究；相关成本和效用数据来自国内外文献。对成本-效用分析结果进行单因素敏感性分析和概率敏感性分析。结果：罗沙司他总治疗成本为44 940.33元，重组人促红素总治疗成本为18 732.60元，使用罗沙司他的患者可获得的QALY为9.51，使用重组人促红素的患者可获得的QALY为9.38，增量成本效果比（ICER）分析显示：ICER为201 597.92元/QALY，小于3倍人均GDP。因此，与重组人促红素相比，罗沙司他治疗NDD-CKD患者具有一定的成本-效用优势。结论：在中国目前的经济情况下，罗沙司他在治疗NDD-CKD患者贫血时具有一定的经济学优势。

Evaluation of the economics of roxadustat versus recombinant human erythropoietin in the treatment of renal anemia in non-dialysis patients based on Markov model

OBJECTIVE From the perspective of the medical system, compare the economy of roxadustat and recombinant human erythropoietin in the treatment of anemia in Nondialysis dependent-Chronic kidney disease(NDD-CKD) patients, and provide a reference for the treatment of renal anemia.METHODS Markov model was used to the cost and effectiveness of roxadustat and recombinant human erythropoietin, and the treatment cost and quality adjusted life year(QALY) of patients were obtained.Clinical parameters were obtained from DOLOMITES study.The relevant cost and utility data were from the domestic and foreign researches.Single factor sensitivity analysis and probability sensitivity analysis were conducted for the cost analysis results.RESULTS The total treatment cost of roxadustat was 44 940.33 yuan, and the total treatment cost of recombinant human erythropoietin was 18 732.60 yuan, 9.51QALYs for patients using roxadustat, 9.387QALYs for the patients using recombinant human erythropoietin.The incremental cost-effectiveness ratio(ICER) analysis showed that ICER was 201 597.92 yuan/QALY.It was less than 3 times GDP per capita.Therefore, compared with recombinant human erythropoietin, roxadustat has a cost-utility advantage in patients with NDD-CKD.CONCLUSION In China's economic situation, roxadustat has certain economic benefits in treating of anemia in NDD-CKD patients compared with recombinant human erythropoietin.