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J Viral Hepat：在日本，采用口服DAA药物治疗HCV基因1b型患者，显著增加了直接和间接经济效益

2018-02-28 MedSci MedSci原创

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在日本，采用口服DAA药物治疗HCV基因1b型患者，由于减少HCC和失代偿性肝硬化的发生，而显著地增加了直接和间接经济效益

研究背景：肝细胞癌是HBV和HCV感染导致的严重并发症之一。HCV患者获得可持续病毒学应答（SVR）与肝硬化、肝癌和相关死亡以及相关花费的减少相关。日本高龄的HCV患者患HCC的机率较高。本研究旨在采用决策分析马尔科夫模型分析通过减少HCC和失代偿性肝硬化，获得的经济效益。

研究方法：本研究纳入10000例HCV基因1b型患者。采用混合决策树和马尔可夫状态转换模型，捕捉HCV在生命周期内的自然历史。治疗方案被批准为采用全口服直接作用的抗病毒药物(DAAs)和不治疗方案。治疗效果基于临床试验、转移率和费用。对采用直接抗病毒治疗与不治疗的HCC、失代偿肝硬化(DCC)和质量调整生命年(QALYs)的病例进行了预测。质量调整生命年(QALYs)通过愿意支付4到6百万日元被货币化。通过增加在并发症上的预计费用，来计算节省的治疗费用。

研究结果：分析模型表明，相比不治疗的策略，采用DAA治疗减少了2057例HCC和1478例失代偿性肝硬化的发生；为每个患者(ppt)节省了850，446.73、338，229.90日元。除此之外，治疗使每位患者额外获得2.64 QALYs。与治疗导致QALY改善相关的间接的经济效益，分别为10，576，000日元、13，220，000日元和15，864，000日元/每位患者(愿意支付400万日元、500万日元和600万日元的阈值)。在不同的支付阈值上，采用DAAs( vs不接受治疗)治疗节省的费用分别为7526，372.63、10，170，372.63和12，814，372.63日元。

研究结论：在日本，采用口服DAA药物治疗HCV基因1b型患者，由于减少HCC和失代偿性肝硬化的发生，而显著地增加了直接和间接经济效益。

原始出处

Younossi ZM， Tanaka A， Eguchi Y， et al. Treatment of Hepatitis C Virus Leads to Economic Gains Related to Reduction in Cases of Hepatocellular Carcinoma and Decompensated Cirrhosis in Japan. J Viral Hepat， 2018， Feb 25. doi： 10.1111/jvh.12886.

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    2018-05-10 经常头晕

    #DAA药物#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1952110, encodeId=03e0195211063, content=<a href='/topic/show?id=50705650a2' target=_blank style='color:#2F92EE;'>#DAA药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5650, encryptionId=50705650a2, topicName=DAA药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu May 10 05:10:00 CST 2018, time=2018-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257719, encodeId=be8b125e719a7, content=<a href='/topic/show?id=774e856e22' target=_blank style='color:#2F92EE;'>#HCV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8567, encryptionId=774e856e22, topicName=HCV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=460849, createdName=ymljack, createdTime=Fri Mar 02 12:10:00 CST 2018, time=2018-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1294395, encodeId=0bc112943950c, content=<a href='/topic/show?id=ca6e592189b' target=_blank style='color:#2F92EE;'>#日本#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59218, encryptionId=ca6e592189b, topicName=日本)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Fri Mar 02 12:10:00 CST 2018, time=2018-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361836, encodeId=fa581361836a1, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Fri Mar 02 12:10:00 CST 2018, time=2018-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427030, encodeId=cb2c142e0301b, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Fri Mar 02 12:10:00 CST 2018, time=2018-03-02, status=1, ipAttribution=)]
    2018-03-02 ymljack

    #HCV#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1952110, encodeId=03e0195211063, content=<a href='/topic/show?id=50705650a2' target=_blank style='color:#2F92EE;'>#DAA药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5650, encryptionId=50705650a2, topicName=DAA药物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu May 10 05:10:00 CST 2018, time=2018-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257719, encodeId=be8b125e719a7, content=<a href='/topic/show?id=774e856e22' target=_blank style='color:#2F92EE;'>#HCV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8567, encryptionId=774e856e22, topicName=HCV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=460849, createdName=ymljack, createdTime=Fri Mar 02 12:10:00 CST 2018, time=2018-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1294395, encodeId=0bc112943950c, content=<a href='/topic/show?id=ca6e592189b' target=_blank style='color:#2F92EE;'>#日本#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59218, encryptionId=ca6e592189b, topicName=日本)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Fri Mar 02 12:10:00 CST 2018, time=2018-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361836, encodeId=fa581361836a1, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Fri Mar 02 12:10:00 CST 2018, time=2018-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427030, encodeId=cb2c142e0301b, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Fri Mar 02 12:10:00 CST 2018, time=2018-03-02, status=1, ipAttribution=)]
    2018-03-02 chentianping

    #日本#

    0

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    2018-03-02 qingting

    #DAA#

    0

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    2018-03-02 gwc384

    #EPA#

    0