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[加兰他敏在德国背景下的成本效益]

[Cost-effectiveness of galantamine in a german context].

作者信息

Happich Michael, Schweikert Bernd, Mühlbacher Axel

机构信息

GSF-Forschungszentrum für Umwelt und Gesundheit, Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Neuherberg.

出版信息

Psychiatr Prax. 2005 Apr;32(3):142-50. doi: 10.1055/s-2004-834709.

Abstract

OBJECTIVE

The application of acetylcholinesterase (AChE) inhibitors seems to be constrained in the German health care system. We investigate the cost-effectiveness of the AChE inhibitor Galantamine for patients with Alzheimer's disease (AD) in a German context.

METHOD

A Markov model as the decision theoretic framework is applied to compare two treatment scenarios (Placebo vs. Galantamine). The incremental cost-utility ratio based on different sources of data is calculated as decision criteria.

RESULTS

In the base case, the application of the AChE inhibitor Galantamine is a dominant scenario with cost savings along with gained quality adjusted life years. It is not cost saving from the perspective of third party payers in Germany. Results are sensitive regarding assumptions about efficacy of the drug and mortality in the analysed cohort.

CONCLUSION

The German reimbursement system places an obstacle to the application of Galantamine. Further research is needed to tackle uncertainties in the model.

摘要

目的

在德国医疗保健系统中,乙酰胆碱酯酶(AChE)抑制剂的应用似乎受到限制。我们在德国背景下研究了AChE抑制剂加兰他敏对阿尔茨海默病(AD)患者的成本效益。

方法

应用马尔可夫模型作为决策理论框架,比较两种治疗方案(安慰剂与加兰他敏)。计算基于不同数据来源的增量成本效用比作为决策标准。

结果

在基础案例中,AChE抑制剂加兰他敏的应用是一种占优方案,既能节省成本,又能增加质量调整生命年。从德国第三方支付者的角度来看,这并不节省成本。结果对所分析队列中药物疗效和死亡率的假设很敏感。

结论

德国的报销系统对加兰他敏的应用设置了障碍。需要进一步研究以解决模型中的不确定性。

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