活性维生素D及其类似物治疗女性绝经后骨质疏松的经济性

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中图分类号 R956 文献标志码 A 文章编号 00-0408（05）0-09-07

DOI 0.609/j.issn.00-0408.05.0.0

Cost-effectiveness of vitamin D analogue for postmenopausal osteoporosis in women

GUAN Haijing1，XU Yanan1， 2，ZHAO Zhigang1，FAN Changsheng3（1. Dept. of Pharmacy，Beijing Tiantan Hospital，Capital Medical University，Beijing ，China；2. School of Pharmaceutical Sciences，Capital Medical University，Beijing ，China；3. Beijing Medical and Health Economic Research Association， Beijing ，China）

ABSTRACT OBJECTIVE To evaluate the cost-effectiveness of vitamin D analogue for postmenopausal osteoporotic women in China. METHODS A Markov microsimulation model was developed to analyze the clinical and economic outcomes of eldecalcitol， alfacalcidol and calcitriol for postmenopausal osteoporosis from the healthcare system perspective in China. The clinical parameters required for the model were derived from network meta-analysis，while cost and utility data were primarily obtained from the literature. The cycle length was 1 year ，the time horizon was life time，and the willingness-to-pay threshold was 0.5 times the gross domestic product per capita in China in 2023（44 679 yuan/QALY）. Model uncertainty was tested with one-way sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis. RESULTS The quality-adjusted life years （QALYs） for eldecalcitol were calculated to be 12.03 QALYs，which were higher than those for alfacalcidol（11.94 QALYs）and calcitriol（11.92 QALYs）. Meanwhile，the direct medical cost associated with eldecalcitol treatment amounted to 38 805 yuan，which was lower than that of alfacalcidol（45 173 yuan）and calcitriol（45 821 yuan）. The results of the one-way sensitivity analysis showed that the risk ratio of hip fracture and vertebral fracture had a significant impact on the result. The probabilistic sensitivity analysis and scenario analysis showed the robustness of the findings from the base-case analysis. CONCLUSIONS Compared with alfacalcidol and calcitriol，eldecalcitol is likely to be a cost-effective treatment for postmenopausal osteoporotic women in China.

KEYWORDS postmenopausal osteoporosis；vitamin D analogue；alfacalcidol；calcitriol；eldecalcitol；cost-effectiveness

骨质疏松是全球范围内影响公众健康的主要问题之一。（剩余16334字）