Evaluating the cost utility of estradiol plus dydrogesterone for the treatment of menopausal women in China.

IF 2.9 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Journal of Medical Economics Pub Date : 2024-01-01 Epub Date: 2023-12-11 DOI:10.1080/13696998.2023.2289297
Rautenberg Tamlyn Anne, Martin Downes, Tommaso Simoncini, Qi Yu, Mulan Ren, Yaping Wang, Custodio Marcelo Graziano, Kyoo Kim
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Abstract

Aim: Evaluate the cost utility of menopausal hormone therapy for women in China.

Materials and methods: A bespoke Markov cost utility model was developed to evaluate a cohort of symptomatic perimenopausal women (>45 years) with intact uterus in China in accordance with China's Pharmacoeconomic guideline. Short (5-year) and long (10-year) treatment durations were evaluated over a lifetime model time horizon with 12-month cycle duration. Societal and healthcare payer perspectives were evaluated in the context of a primary care provider/prescriber, outpatient setting with inpatient care for patients with chronic conditions. Disease risk and mortality parameters were derived from focused literature searches, and China Diagnosis-related Group cost data was included. Comprehensive scenario, univariate and probabilistic sensitivity analysis were undertaken along with independent validation. This is the first model to include MHT-related disease risks.

Results: According to base case results, the total cost for MHT was 22,516$ (150,106¥) and total quality adjusted life years 12.32 versus total cost of no MHT 30,824$ (205,495¥) and total quality adjusted life years 11.16 resulting in a dominant incremental cost effectiveness ratio of -7,184$ (-47,898¥) per QALY. Results hold true over a range of univariate deterministic sensitivity and scenario analyses. Probabilistic analysis showed a 91% probability of being cost effective at a willingness to pay threshold of three times Gross Domestic Product per capita in China.

Conclusion: Contingent on the structure and assumptions of the model, combination of estradiol plus dydrogesterone MHT is potentially cost saving in symptomatic women over the age of 45 years in China.

评价雌二醇加地屈孕酮治疗中国更年期妇女的成本效用。
目的:评价中国妇女绝经期激素治疗的成本效用。材料与方法:根据中国药物经济学指南,建立定制马尔可夫成本实用模型,对中国有症状的子宫完整围绝经期妇女(>45岁)进行队列评估。短期(5年)和长期(10年)的治疗持续时间以12个月的周期为生命周期模型时间范围进行评估。社会和医疗保健支付者的观点被评估的背景下,初级保健提供者/处方,门诊设置与住院治疗的慢性疾病患者。疾病风险和死亡率参数来源于重点文献检索,并纳入了中国诊断相关组的费用数据。进行综合情景分析、单变量分析和概率敏感性分析,并进行独立验证。这是第一个包含mht相关疾病风险的模型。结果:根据基本案例结果,MHT的总成本为22,516美元(150,106日元),总质量调整寿命年为12.32年,而没有MHT的总成本为30,824美元(205,495日元),总质量调整寿命年为11.16年,导致每个QALY的主要增量成本效益比为-7,184美元(-47,898日元)。结果在单变量确定性敏感性和情景分析的范围内成立。概率分析显示,在中国,支付意愿阈值为人均国内生产总值(gdp)的三倍时,具有成本效益的概率为91%。结论:根据模型的结构和假设,在中国45岁以上有症状的女性中,雌二醇联合地孕酮MHT可能节省成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Medical Economics
Journal of Medical Economics HEALTH CARE SCIENCES & SERVICES-MEDICINE, GENERAL & INTERNAL
CiteScore
4.50
自引率
4.20%
发文量
122
期刊介绍: Journal of Medical Economics'' mission is to provide ethical, unbiased and rapid publication of quality content that is validated by rigorous peer review. The aim of Journal of Medical Economics is to serve the information needs of the pharmacoeconomics and healthcare research community, to help translate research advances into patient care and be a leader in transparency/disclosure by facilitating a collaborative and honest approach to publication. Journal of Medical Economics publishes high-quality economic assessments of novel therapeutic and device interventions for an international audience
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