Semin Arthritis Rheu:骨折风险升高女性使用阿巴帕肽vs.特立帕肽序贯治疗的成本效益

2019-01-15 xiangting MedSci原创

对于骨折风险升高的美国女性,与TPTD/ALN序贯治疗相比,ABL/ALN序贯治疗是一种极具成本效益(主导)的治疗策略。

有新的证据支持脆性骨折高危患者在骨代谢序贯疗法后,接受抗骨吸收治疗。这项研究评估了与特立帕肽(TPTD)/阿伦膦酸盐(ALN)序贯治疗(TPTD/ALN)比较,阿巴帕肽(ABL)/阿伦膦酸盐(ABL/ALN)序贯治疗的成本效益。

从美国付款人的角度在终生范围内,采用既往验证的马尔可夫微观模拟模型估算与TPTD/ALN序贯治疗和不治疗相比,ABL/ALN的成本效益。假设患者接受ABL或TPTD治疗18个月,然后根据临床威廉亚洲博彩公司 接受5年ALN治疗。ABL对骨折风险的影响来自ACTIVExtend试验。假设随后的ALN治疗期间TPTD仍保持作用,与ABL的ACTIVExtend结果一致。对年龄50-80岁,BMD T评分≤-3.5或T评分-2.5至-3.5,并有≥1次骨质疏松骨折史的患者进行评估。

在所有的模拟人群中,与TPTD/ALN序贯治疗相比,ABL/ALN序贯治疗有优势(成本更低、QALYs更多),这是由于ABL的疗效更好、价格更低。概率敏感性分析表明ABL/ALN在至少99%的模拟中占优势。与无治疗相比,ABL/ALN获得的每个QALY成本总是低于130,000美元。

对于骨折风险升高的美国女性,与TPTD/ALN序贯治疗相比,ABL/ALN序贯治疗是一种极具成本效益(主导)的治疗策略。

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    2019-01-17 zhaojie88
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