琥珀酸地文拉法辛与盐酸托鲁地文拉法辛在重性抑郁障碍治疗中的疗效与成本比较

Comparative efficacy and cost analysis of desvenlafaxine succinate and toludesvenlafaxine hydrochloride in the treatment of major depressive disorder

摘要

目的: 采用匹配调整间接比较(matching-adjusted indirect comparison, MAIC)方法,比较琥珀酸地文拉法辛(desvenlafaxine succinate, DVS)与盐酸托鲁地文拉法辛(toludesvenlafaxine hydrochloride, TDVH)治疗重性抑郁障碍(major depressive disorder, MDD)的疗效及成本效益。方法: 基于一项多中心、随机、双盲、阳性对照临床试验,收集177例DVS患者数据,并以TDVH Ⅲ期临床试验公开汇总数据作为对照。通过MAIC对基线特征进行加权匹配,比较两组在HAMD-17、HAMA和CGI-S评分上的变化,并计算总治疗成本及单位改善成本。结果: DVS在HAMD-17、HAMA和CGI-S评分上的改善幅度分别为66.1%、50.6%和57.3%,TDVH分别为59.8%、58.1%和49.0%。在相同治疗周期内,基于HAMD-17改善率的比较结果显示,DVS的总治疗成本及单位改善成本均低于TDVH。结论: 经MAIC调整后,DVS在疗效和成本效益方面具有优势,显示出较高的经济可及性,可为MDD治疗药物选择及医保决策提供参考。

Abstract

Objective: To compare the clinical efficacy and cost-effectiveness of desvenlafaxine succinate (DVS) and toludesvenlafaxine hydrochloride (TDVH) in the treatment of major depressive disorder (MDD) using the matching-adjusted indirect comparison (MAIC) method. Methods: Based on a multicenter, randomized, double-blind, positive-controlled clinical trial, data from 177 DVS patients were included and compared with the publicly available summary data from the TDVH Phase Ⅲ trial. MAIC was used to perform weighted matching on baseline characteristics, and changes in the 17-item Hamilton Rating Scale for Depression (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), and Clinical Global Impression-Severity Scale (CGI-S) scores were compared between the two groups. The total treatment cost and cost per unit improvement were calculated. Results: The improvement rates in HAMD-17, HAMA, and CGI-S scores were 66.1%, 50.6%, and 57.3% in the DVS group, compared with 59.8%, 58.1%, and 49.0%, respectively, in the TDVH group. Both the total treatment cost and the cost per unit improvement were lower for DVS than those for TDVH. Conclusion: DVS demonstrated advantages in efficacy and cost-effectiveness, indicating greater economic accessibility and providing a reference for drug selection and reimbursement decision-making in MDD treatment.

关键词

琥珀酸地文拉法辛 / 盐酸托鲁地文拉法辛 / 重性抑郁障碍 / 匹配调整间接比较 / 成本效益比分析

Key words

desvenlafaxine succinate / toludesvenlafaxine hydrochloride / major depressive disorder / matching-adjusted indirect comparison / cost-effectiveness ratio

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基金资助

河北省药学会三类药品临床综合评价专项课题研究资助项目:自拟课题“抗抑郁类药品的临床综合评价”(2023-Hbsyxhdx003)