非奈利酮联合标准方案治疗射血分数轻度降低型或保留型心力衰竭的药物经济学评价

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中图分类号R956 文献标志码A 文章编号 1001-0408（2025）14-1770-05

DOI 10.6039/j.issn.1001-0408.2025.14.14

ABSTRACTOBJECTIVEToevaluate thecost-efectivenessof finerenonecombinedwith standardofcare（SoC）inthe treatmentofheartfailurewithmildlyreducedejectionfraction（HFmrEF）orpreservedejectionfraction（HFpEF）.METHODS BasedonaphaseIIclinical tial，a MarkovmodelwasconstructedfromtheperspectiveofChina’shealthcaresystemtocompare thetreatmentoutcomesoffinerenonecombinedwithSoCregimenversusSoCregimenaloneinthetreatmentofdiferentcardiac functionalstatusesofHFmrEF/HFpEF.Usingquality-adjustedlifeyear（QALY）asthehealthoutputindex，3times China’sper capita GDPin2023asthewilingnes-to-pay（WTP）threshold，asimulationwasconducted witha3-monthcyclelengthanda10- year time horizon，incorporating an annual discount rate of 5% .The dynamic changes across various stages of HFmrEF/HFpEF treatedwith finerenonecombinedwithSoCversusSoCaloneweresimulatedtoevaluatethelong-termefectivenessandcostsof the twotreatmentstrategies.Additionally，oe-waysensitivityanalysisndprobabilisticsnsitivityanalysswereperformed，totesthe robustnessof theresults.RESULTSTheicrementalcost-efectivenessratio（ICER）ofthefinerenonecombinedwith SoCregimen versusSoCregimenalonewas179504.75yuan/QALY，whichwas belowtheWTPthresholdset inthis study，indicating thatthe finerenonecombinedwith SoCregimenposessedcertaineconomicadvantages.Theresultsofone-waysensitivityanalysis showed thattheutiltyvalueofNYHAIstatus，thedrugpriceoffierenone，thediscountrate，andtheprobabilityofhospital tansfefor bothgroups hadagreat influenceonICER，butdidnotafect therobustessofthemodel.Theprobabilisticsensitivityanalysisalso confirmedtherobustnessof the model.CONCLUsIONS Under theWTPthresholdset inthis study，finerenonecombined with SoC is cost-effective in the treatment of HFmrEF/HFpEF，compared with the SoC regimen.

KEYWORDSfinerenone；HFmrEF；HFpEF；Markov model；cost-utility analysis

心力衰竭（heartfailure，HF）是各种心脏疾病的严重表现或晚期阶段，以呼吸困难、疲乏和液体潴留等为主要临床表现，具有较高的患病率和死亡率[1-2]。（剩余10070字）