Abstract：
UNASSIGNED: To evaluate the cost-effectiveness of budesonide/formoterol reliever and maintenance therapy compared with salmeterol/fluticasone plus salbutamol as reliever therapy for asthma patients ≥12 years from the societal perspective in China.
UNASSIGNED: A Markov model was developed with three health states (non-exacerbation, exacerbation, and death) with a lifetime horizon. The exacerbation rates were obtained from a prospective cohort study conducted in Chinese asthma patients. Healthcare resources utilization data were estimated based on current clinical asthma management guidelines. Asthma-related mortality, cost input and utility values were derived from public database and literature. Model robustness was assessed with one-way sensitivity and probabilistic sensitivity analyses.
UNASSIGNED: Compared with salmeterol/fluticasone plus salbutamol, budesonide/formoterol reliever and maintenance therapy led to fewer exacerbation events (13.6 vs. 15.9) and 0.0077 quality-adjusted life years (QALY) gain at an additional cost of ¥196.38 over lifetime. The base case incremental cost-effectiveness ratio (ICER) was ¥25,409.98 per QALY gained. The variables that had most impact on the model output included drug costs and medication adherence. At a willingness-to-pay threshold of ¥257,094/QALY (3 times of gross domestic product per capita in China in 2022), the probability of budesonide/formoterol maintenance and reliever therapy being cost-effective versus salmeterol/fluticasone plus as-needed salbutamol was 83.00%.
UNASSIGNED: From the societal perspective, budesonide/formoterol reliever and maintenance therapy is likely to be a cost-effective option compared with salmeterol/fluticasone plus as-needed salbutamol for Chinese asthma patients ≥12 years.
UNASSIGNED: A Markov model was developed with three health states (non-exacerbation, exacerbation, and death) with a lifetime horizon. The exacerbation rates were obtained from a prospective cohort study conducted in Chinese asthma patients. Healthcare resources utilization data were estimated based on current clinical asthma management guidelines. Asthma-related mortality, cost input and utility values were derived from public database and literature. Model robustness was assessed with one-way sensitivity and probabilistic sensitivity analyses.
UNASSIGNED: Compared with salmeterol/fluticasone plus salbutamol, budesonide/formoterol reliever and maintenance therapy led to fewer exacerbation events (13.6 vs. 15.9) and 0.0077 quality-adjusted life years (QALY) gain at an additional cost of ¥196.38 over lifetime. The base case incremental cost-effectiveness ratio (ICER) was ¥25,409.98 per QALY gained. The variables that had most impact on the model output included drug costs and medication adherence. At a willingness-to-pay threshold of ¥257,094/QALY (3 times of gross domestic product per capita in China in 2022), the probability of budesonide/formoterol maintenance and reliever therapy being cost-effective versus salmeterol/fluticasone plus as-needed salbutamol was 83.00%.
UNASSIGNED: From the societal perspective, budesonide/formoterol reliever and maintenance therapy is likely to be a cost-effective option compared with salmeterol/fluticasone plus as-needed salbutamol for Chinese asthma patients ≥12 years.
摘要：
目的：从社会角度评估布地奈德/福莫特罗缓解剂和维持治疗与沙美特罗/氟替卡松联合沙丁胺醇缓解治疗≥12年哮喘患者的成本-效果。方法：建立了具有三种健康状况(非恶化，恶化,和死亡）与一生的地平线。急性加重率来自对中国哮喘患者进行的前瞻性队列研究。根据当前的临床哮喘管理指南估计医疗资源利用数据。哮喘相关死亡率,成本投入和效用值来自公共数据库和文献。通过单向灵敏度和概率灵敏度分析评估模型的稳健性。结果:与沙美特罗/氟替卡松+沙丁胺醇相比,布地奈德/福莫特罗缓解剂和维持治疗导致急性加重事件减少(13.6vs.15.9）和0.0077质量调整寿命年（QALY）收益，整个寿命期间的额外成本为196.38日元。基本情况增量成本效益比（ICER）为每QALY25,409.98日元。对模型输出影响最大的变量包括药物成本和药物依从性。支付意愿门槛为257,094日元/QALY（2022年为中国人均国内生产总值的3倍），布地奈德/福莫特罗维持和缓解治疗与沙美特罗/氟替卡松加视需要沙丁胺醇相比具有成本效益的概率为83.00%.结论：从社会的角度来看，对于≥12岁的中国哮喘患者,与沙美特罗/氟替卡松加按需沙丁胺醇相比,布地奈德/福莫特罗缓解剂和维持治疗可能是一种具有成本效益的选择.
