芪骨胶囊与仙灵骨葆胶囊治疗原发性骨质疏松症的成本效果分析

Cost-effectiveness analysis of Qigu Capsules and Xianlinggubao Capsules in treatment of primary osteoporosis in China

目的比较芪骨胶囊与仙灵骨葆胶囊治疗原发性骨质疏松症的经济性,为临床决策提供参考与建议。方法从全社会角度出发,通过建立决策树模型对芪骨胶囊与仙灵骨葆胶囊治疗方案进行成本效果分析,并针对参数的不确定性进行敏感性分析。结果芪骨胶囊治疗骨质疏松症的总成本为1 998.93元人民币,仙灵骨葆胶囊方案的总成本为1 428.44元;芪骨胶囊方案的有效率为99.72%,仙灵骨葆胶囊方案的有效率为98.32%;与仙灵骨葆胶囊相比,芪骨胶囊治疗骨质疏松症的增量成本效果比为40 779.00,即每多避免1例骨折发生,多花费的成本为40 779.00元。单因素敏感性分析结果与基础分析结果一致。概率敏感性分析结果显示,当意愿支付值小于60 000元人民币时,仙灵骨葆胶囊为较优方案,当意愿支付值达到60 000元时,芪骨胶囊更具有显著的成本效果优势。结论综合考虑骨折后治疗费用及患者生存质量的降低,两方案皆可被作为临床推荐用药,患者可根据自身的经济条件选择适合的治疗方案。

Objective The objective of this study was to evaluate and compare the cost effectiveness of Qigu Capsules and Xianlinggubao Capsules for Chinese primary osteoporosis patients,and to provide some advice to clinicians.Methods A decision tree model was used to perform the cost-effectiveness analysis of Qigu Capsules and Xianlinggubao Capsules from the societal perspective.The uncertainty of parameters was estimated by sensitivity analysis.Results The total cost for Qigu Capsules group was ￥1 998.93,while the total cost for Xianlinggubao Capsules was ￥1 428.44.The effective rate of Qigu Capsules group was 99.72%,and the effective rate of Xianlinggubao was 98.32%.The ICER was 40 779.00 which means Qigu Capsules group cost more ￥40 779.00 to avoid one case of fractures.Result of one-way sensitivity analysis was the same with fundamental analysis.Probabilistic sensitivity analyses indicated that when the threshold value of willingness to pay(WTP)is less than ￥60 000,Xianlinggubao Capsules is the most cost-effective,and when the threshold value is over ￥60 000,Qigu Capsules has significant cost-effective advantage.Conclusions Considering the current economic burden of fractures in China and the reduction of the quality of life of patients,both treatments are recommended for clinical use,and patients should choose the most appropriate treatments according to their WTP.