司美格鲁肽对比卡格列净治疗二甲双胍控制不佳的2型糖尿病患者的成本-效用分析

药物经济学

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中图分类号R956 文献标志码A 文章编号 1001-0408（2025）09-1087-06

DOI10.6039/j.issn.1001-0408.2025.09.12

ABSTRACTOBJECTIVEToevaluate thelong-termcost-efectivenessofcanagiflozinorsemaglutideinpatientswithtype2 diabetes melltus（T2DM）poorlycontroled with metformin.METHODs Basedontheperspectiveof China's health system，a Markovmodel wasused tocalculatethelong-termcostsandutiliesofcanagliflozinorsemaglutidecombined with metforminfor T2DM patients in China for30yearsbasedonthedata from SUSTAIN8studyTheincrementalcost-efectivenessratio（ICER）and incrementalnet monetary benefit （INMB）werecalculatedusing one timethe 2024 percapita gross domestic product（GDP）as the wilingness-to-pay（WTP）threshold.One-waysensitivityanalysis，probabitysensitivityanalysisandscenarioanalysiswere conducted to confirm the stability of the conclusions.RESULTS Compared with canagliflozin + metformin，ICER of semaglutide combinedwithmetforminwas26O485.67yuan/quality-adjustedlifeyear（QALY），whichwashigherthantheWTPthresholdsetin this study（95 749 yuan/QALY），and the corresponding INMB was - 6 1 5 7 6 . 2 4 yuan，indicatingthat the canagliflozin + metformin regimen was more cost-effective.The cost of diabetes without complications treatment in the semaglutide + metformin group had thegreatest influenceonINMB，butchangesinparameterswithintheselectedrangedidnotdrive decisionreversal.Withthe increasingofWTP threshold，the economic acceptability of semaglutide + metformin regimen increased.Under the current WTP threshold，the annual cost of semaglutide should be reduced by 4 2 . 9 5 % to make the semaglutide + metformin regimen more cost

effective. CONCLUSIONS From the perspective of China's healthsystem， canagliflozin + metformin is more costeffective than semaglutide + metformin for T2DM patients withpoor glycemic control with metformin alone.

KEYWORDSsemaglutide； canagliflozin；metformin；type2 diabetes mellitus；poor glycemic control；Markov model;pharmacoeconomics；cohort simulation

糖尿病是一种以慢性高血糖为特征的代谢性疾病，其中2型糖尿病（type2diabetesmellitus，T2DM）患者占糖尿病患者总人数的 9 0 % 以上。（剩余12316字）