达格列净与恩格列净治疗2型糖尿病肾病的药物经济学评价

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中图分类号R956 文献标志码A 文章编号 1001-0408（2025）18-2285-06

DOI10.6039/j.issn.1001-0408.2025.18.12

Pharmacoeconomic evaluation of dapagliflozin and empagliflozin in the treatment of type 2 diabetic kidney disease

YANG Xu，ZHAO Yifan，LI Wanting，LIU Yongjun（School of International Pharmaceutical Business，China Pharmaceutical University，Nanjing ，China）

ABSTRACTOBJECTIVEToevaluate thecost-efectiveness of dapagliflozinand empagliflozininthe treatmentof type 2 diabetic kidneydiseasefromtheperspectiveofhealthcaresysteminChina.METHODSBasedonthedatafromthetwomulticenter clinical trials，DECLARE-TIMI 58andEMPA-REG OUTCOME，a Markovmodelwasconstructedaccording totheurinary albumin-to-creatinineratio（UACR）ofthe patients with type2 diabetic kidney disease withacycleoflyear，simulating until 99% （204号 of patientsdied.Themodeloutputswere totalcostsandquality-adjustedlifeyear（QALY）.Thecost-efectivenessof the two treatmentregimens wasassedbycomparing theirincrementalcost-efectivenessratio（ICER）andthewillngness-to-pay threshold（WTP，setatthreetimesChina’s2023percapitagrossdomesticproduct，i.e.，268074yuan/QALY）.Aditionally， onewaysenstivityanalysisandprobabilsticsensitivityanalysiswereperformedtotesttherobustnessofthebaseanalysisesults. RESULTSComparedwithdapagliflozin，theICERforempagliflozinregimen was44 334.82yuan/QALY，which wasbelowthe WTP，indicatingitscost-efectivenessTheresultsoftheonewaysensitivityaalysisindicatedthattheincidenceofnon-fatal myocardialinfarctioninbothgroupsandtheutilityvaluesasociatedwiththemicroalbuminuriastatehadthemostsignificant impactntheoutcomes，butdidnotchangethebase-caseconclusion.Theprobabilisticsensitivityanalysis indicatedthattheresults of the base-case analysis were robust. CONCLUSIONS With a WTPof threetimes China's percapita gross domestic product in 2023，empagliflozin is more cost-effective than dapagliflozin in treating type 2 diabetic kidney disease.

KEYWORDSdapagliflozin； empagliflozin;cost-utility；Markov model; type 2 diabetic kidney disease

随着全球糖尿病患病率的不断升高，糖尿病肾病的发病率也逐年升高。（剩余12261字）