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临床研究

环硅酸锆钠治疗血液透析伴慢性高钾血症患者的成本-效用分析

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  • 1.昆明市第一人民医院, 云南 昆明 650034;
    2.昆明医科大学, 云南 昆明 650021
毛盼盼,女,硕士,主管药师,研究方向:临床药学。

收稿日期: 2025-07-17

  修回日期: 2025-09-19

  录用日期: 2025-11-27

  网络出版日期: 2025-12-15

基金资助

云南省卫生健康委员会医学领军人才培养项目(L-2018012);昆明市卫生健康委员会带头人才培养项目[2022-SW(带头)-32];云南省教育厅科学研究基金项目(2024J0294)

Cost-utility Analysis of Sodium Zirconium Cyclosilicate in the Treatment of Hemodialysis Patients with Chronic Hyperkalemia

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  • 1.Kunming First People′s Hospital, Yunnan Kunming, 650034, China;
    2.Kunming Medical University, Yunnan Kunming 650021, China

Received date: 2025-07-17

  Revised date: 2025-09-19

  Accepted date: 2025-11-27

  Online published: 2025-12-15

摘要

目的:评估标准治疗和规律服用环硅酸锆钠(sodium zirconium cyclosilicate,SZC)治疗血液透析伴慢性高钾血症患者的经济性,以期为临床用药提供参考依据。方法:数据来源于在昆明市某三甲医院就诊的血液透析伴慢性高钾血症的患者资料和国内外文献。采用Markov模型对标准治疗和规律服用SZC的两组血液透析伴慢性高钾血症患者进行成本-效用分析,比较两组患者在模型模拟治疗过程中产生的成本及质量调整生命年(quality adjusted life year,QALY)。结果:在本研究模型下,模拟长期(10年)的治疗中,标准治疗的血液透析伴慢性高钾血症患者治疗成本为491 517.27元,获得的QALY为8.15年;规律服用SZC的血液透析伴慢性高钾血症患者治疗成本为373 440.10元,获得的QALY为10.83年,获得的增量成本-效果比(incremental cost-effectiveness ratio,ICER)为-44 058.65元/QALY,小于意愿支付阈值(WTP),服用SZC组的患者可节约118 077.17元且多获得2.68个QALY。结论:对于血液透析伴慢性高钾血症患者,SZC的治疗比标准治疗更具有经济优势。

本文引用格式

毛盼盼, 宋沧桑, 张函舒, 王国徽, 王子丹, 李兴德 . 环硅酸锆钠治疗血液透析伴慢性高钾血症患者的成本-效用分析[J]. 中国药物评价, 2025 , 42(5) : 389 -389-393 . DOI: magtech-2025-07-17-00003

Abstract

Objectives: To evaluate the cost-effectiveness of Standard Treatment versus regular sodium zirconium cyclosilicate (SZC) therapy in hemodialysis patients with chronic hyperkalemia, so as to provide a reference for clinical medication. Methods: The data were obtained from medical records of hemodialysis patients with chronic hyperkalemia treated at a tertiary hospital in Kunming, as well as domestic and international literature. A Markov model was used to conduct a cost-utility analysis comparing two groups—those without specific intervention and those receiving regular SZC therapy—to estimate and compare the costs and quality-adjusted life years (QALYs) generated during the simulated treatment process. One-way sensitivity analysis was performed to assess the impact of key parameters on the results. Results: Under the research model, in the simulation of long-term (10-year) treatment, the treatment cost for hemodialysis patients with chronic hyperkalemia without special intervention was 491 517.27 yuan, with a QALY of 8.15 years. For hemodialysis patients with chronic hyperkalemia who regularly took SZC, the treatment cost was 373 440.10 yuan, with a QALY of 10.83 years. The incremental cost-effectiveness ratio (ICER) was -44 058.65 yuan/QALY, which is below the willingness-to-pay (WTP) threshold. Patients in the SZC group saved 118 077.17 yuan and gained an additional 2.68 QALYs. Conclusion: For hemodialysis patients with chronic hyperkalemia, SZC therapy demonstrates greater economic advantages compared to Standard Treatment.

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