基于Markov模型的3种抗血小板药物的经济学评价

目的： 为急性冠状动脉综合征患者提供最具有成本-效果的双联抗血小板疗法决策。方法： 基于PLATO临床试验建立Markov转归模型；通过文献检索确定事件发生率和效用值；依据开滦总医院2018年、2019年数据得到直接成本；运用TreeAge Pro对3种方案进行回乘分析、半循环矫正、成本-效果分析和敏感性分析。结果： 25周期氢氯吡格雷（商品名：泰嘉）、氢氯吡格雷（商品名：波维立）、替格瑞洛（商品名：倍林达）3种方案的人均总成本分别为76 016.46元、103 477.57元、112 793.49元，效果指标质量调整生命年分别为12.14 QALYs、12.04 QALYs、12.41 QALYs，增量成本效果比（ICER）分别为-299 131.61、136 211.22。结论： 与泰嘉相比，波立维不具有经济性，倍林达具有经济性且随着时间推移表现显著。

A Markov pattern analysis about three kinds of dualantiplatelet therapy

OBJECTIVE To provide the most cost-effective dual antiplatelet therapy decision for patients with acute coronary syndrome.METHODS A Markov outcome model was established based on the PLATO clinical trial;the event rate and utility value were determined by literature search;the direct cost was obtained based on the 2018 and 2019 data of kailuan hospital;regression analysis,half-cycle correction,cost-effectiveness analysis,and sensitivity analysis were performed for the three protocols using TreeAge Pro.RESULTS After 25 cycles,The total cost per capita was 76 016.46 yuan,103 477.57 yuan and 112 793.49 yuan,the effect indexes quality adjusted life years(QALYs) were 12.14 QALYs,12.04 QALYs and 12.41 QALYs,and the ICERs were -299 131.61 and 136 211.22,CONCLUSION Plavix is not economical compared to Talcom,and Plinda is economical and performs significantly over time.