摘要
背景：近年来阿尔茨海默病（AD）的免疫治疗获得了动力。其应用的一个问题涉及人口平均和特定亚组差异的成本效益分析（CEA），因为这种治疗对于卫生决策者分配有限资源是必不可少的。然而，这种考虑异质人口和风险因素调整的CEA模型很少得到解决。 方法：我们的目的是显示CEA在AD免疫治疗中的异质性，与没有干预的比较物相比较。经质量调整生命年（QALY），通过增量成本效益比（ICER）和成本效益可接受性曲线（CEAC）进行经济评估。首先，人口平均CEA是在有和没有年龄和性别调整的情况下进行的。其次，根据马尔可夫过程，对性别和年龄的分层进行了分组CEA。 结果：鉴于支付意愿的门槛为20,000美元，ICER的年龄和性别调整结果显示出相似的结果（14,691美元/ QALY和17,604美元/ QALY）。不同年龄组和性别的子组ICER结果显示出显着差异。 CEAC显示，在人口水平的QALY方面，成本效益的概率仅为48.8％-53.3％，而在50-64岁的女性中为85.5％，65-74岁的女性为0.2％，降至0.2％在男性≥75岁。 结论：在接种疫苗的CEA中观察到相当大的异质性。与个性化医疗的发展一样，健康决策者评估的CEA结果不仅应考虑人口平均水平，还应考虑特定的亚群水平。
关键词: 阿尔茨海默病，免疫疗法，疫苗接种，成本效益分析，异质性，个性化医疗。
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