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首页> 外文期刊>Cost Effectiveness Resource Allocation >Cost-utility of Intravenous Immunoglobulin (IVIG) compared with corticosteroids for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) in Canada
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Cost-utility of Intravenous Immunoglobulin (IVIG) compared with corticosteroids for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) in Canada

机译：静脉免疫球蛋白（IVIG）与皮质类固醇相比在加拿大治疗慢性炎性脱髓鞘性多发性神经病（CIDP）的成本效益

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Objectives Intravenous immunoglobulin ( IVIG ) has demonstrated improvement in chronic inflammatory demyelinating polyneuropathy (CIDP) patients in placebo controlled trials. However, IVIG is also much more expensive than alternative treatments such as corticosteroids. The objective of the paper is to evaluate, from a Canadian perspective, the cost-effectiveness of IVIG compared to corticosteroid treatment of CIDP. Methods A markov model was used to evaluate the costs and QALYs for IVIG and corticosteroids over 5 years of treatment for CIDP. Patients initially responding to IVIG could remain a responder or relapse every 12 week model cycle. Non-responding IVIG patients were assumed to be switched to corticosteroids. Patients on corticosteroids were at risk of a number of adverse events (fracture, diabetes, glaucoma, cataract, serious infection) in each cycle. Results Over the 5 year time horizon, the model estimated the incremental costs and QALYs of IVIG treatment compared to corticosteroid treatment to be $124,065 and 0.177 respectively. The incremental cost per QALY gained of IVIG was estimated to be $687,287. The cost per QALY of IVIG was sensitive to the assumptions regarding frequency and dosing of maintenance IVIG . Conclusions Based on common willingness to pay thresholds, IVIG would not be perceived as a cost effective treatment for CIDP.
机译：目的在安慰剂对照试验中，静脉注射免疫球蛋白（IVIG）已证明可改善慢性炎症性脱髓鞘性多发性神经病（CIDP）患者的病情。但是，IVIG也比皮质类固醇等替代疗法昂贵得多。本文的目的是从加拿大的角度评估IVIG与糖皮质激素治疗CIDP相比的成本效益。方法采用马尔可夫模型评估CIDP治疗5年后IVIG和皮质类固醇的费用和QALY。最初对IVIG产生反应的患者可以每12周模型周期保持反应者或复发。无反应的IVIG患者被假定改用糖皮质激素。服用糖皮质激素的患者在每个周期中都有许多不良事件（骨折，糖尿病，青光眼，白内障，严重感染）的风险。结果在5年的时间范围内，该模型估计与糖皮质激素治疗相比，IVIG治疗的增量成本和QALY分别为124,065美元和0.177美元。 IVIG获得的每QALY增量成本估计为687,287美元。 IVIG的每QALY成本对有关IVIG维护频率和剂量的假设很敏感。结论基于一般的支付意愿，IVIG不会被视为CIDP的一种经济有效的治疗方法。

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