中药骨康治疗绝经后骨质疏松症卫生经济学分析

The medical economic analysis on the treatment of postmenopausal osteoporosis with Gukang

目的探讨治疗绝经后骨质疏松症有良好成效比的药物,为卫生资源的合理使用提供理论依据。方法选取符合骨质疏松症诊断标准和排除标准的绝经后骨质疏松症患者95例,随机分为中药骨康治疗组和固邦对照组进行1年的治疗,采用成本-效果分析和成本-效用分析的方法,统计两组治疗期间的门诊、检查及药物治疗的成本,并运用QUALEFFO-41量表分别进行治疗前后的生存质量调查。结果①以生存质量总评分为效果进行成本-效果分析(CEA),治疗组的CEA为:231.00,对照组为:366.15,治疗组的CEA较对照组低。②两组进行成本-效用分析(CUA)治疗组的CUA为:46403.92元/QALY,对照组为:72648.72元/QALY。③进行敏感度分析,治疗组治疗成本提高10%后,治疗组成本-效果比值和成本-效用比值仍比对照组低。结论两组以生存质量总评分为效果进行成本-效果分析,中药骨康比固邦有更佳的成本-效果比。两组都增加患者的质量调整生命年,具有良好的成本-效用比。与固邦相比,中药骨康有更好的成本-效用和成本-效果比。因此,中药骨康能比固邦以更少治疗成本获得更大的效益。

Objective To discuss the medicine with good effectiveness proportion to treat postmenopausal osteoporosis and to provide the theory basis for the reasonable use of health resources.Methods 95 patients who were consistent with osteoporosis diagnostic criteria and exclusion criteria,were randomly divided into the treatment group and the control group.Patients of the treatment group were given administration with GuKang,the control group were given administration with Alendronate.After one year of treatment,cost-effectiveness analysis and cost-utility analysis were used to calculate the costs of both group,which included the outpatient service cost,examination cost,and the medicine cost.Simultaneously,the QUALEFFO-41 were used to investigate the quality of life before and after treatment.Results ①The total score of the quality of life as the effectiveness is carried on the cost-effectiveness analysis（CEA） on both group,the CEA of the treatment group is 231.00,which is lower than that of the control group（366.15）.②Both groups are carried on the cost-utility analysis（CUA）,the CUA of the treatment group is 46403.92Yuan/QALY,which is lower than that of the control group（72648.72 Yuan/QALY）.③Both groups are carried on the sensitivity analysis.The cost of the treatment group increases by 10% and the ratio of CEA and CUA of the treatment group is lower than that of control group.Conclusion When the total score of the quality of life as the effectiveness is carried on the cost-effectiveness analysis（CEA） on both group,the treatment group is better than the control group.Both can obtain cost per quality-adjusted life year（QALY）,and has the good cost-effectiveness ratio.Compared with the control group,the treatment group has the better ratio of CEA and CUA.So Gukang costs less to gain greater efficiency,compared with Alendronate.