奇正消痛贴膏治疗急性腰扭伤的药物经济学评价

Pharmacoeconomic Evaluation of QiZheng XiaoTong Plaster Treating Acute Lumbar Sprain

目的基于社会角度,通过成本-效果分析和成本-效用分析评价奇正消痛贴膏与双氯芬酸钠乙二胺乳胶剂治疗急性腰扭伤的经济学优劣,为急性腰扭伤的治疗方案选择提供依据。方法选取2012年7月至2013年6月来自北京、上海、广州和通辽4个城市5所三级医院的急性腰扭伤患者295例,其中奇正消痛贴膏治疗组152例,双氯芬酸钠乙二胺乳胶剂治疗组143例。选取疼痛消失时间为效果指标,质量调整生命年(QALYs)为效用指标,进行成本-效果分析及成本-效用分析。结果与双氯芬酸钠乙二胺乳胶剂治疗组相比,奇正消痛贴膏治疗组疼痛消失时间显著缩短(8.26 d对9.23 d,P<0.001),且获得更多的QALYs(0.0362对0.0359,P=0.597),但治疗成本也更高(308.52元对297.43元,P=0.697)。增量成本效果比(ICER)为-11.43元/d,即减少1天疼痛时间需多花费11.43元。增量成本效用比(ICUR)为36 966.67元/QALY,低于世界卫生组织(WHO)所建议的成本效用阈值115 000元(人均GDP的3倍)。结论在急性腰扭伤的治疗中,外用止痛药物奇正消痛贴膏是非常具有成本-效益的治疗方案。

Objective To evaluate cost-efectiveness and cost-utility of QiZheng XiaoTong plaster and Diclofenac Diethylamine Emulgel for the treatment of acute lumbar sprain,in order to provide evidence for clinical strategy choice.Methods From July 2012 to June 2013,295 patients with acute lumbar sprain were selected from five tertiary hospitals in Beijing,Shanghai,Guangzhou and Tongliao.152 patients are assigned to QiZheng XiaoTong plaster treatment group and 143 to Diclofenac Diethylamine Emulgel treatment group.Pain recovery time is chosen as the efectiveness indexes and the Quality adjusted Life years （QALYs） as utility index.Efectiveness,utility and cost of the two treatment schemes are compared with the method of cost-efectiveness analysis and cost-utility analysis.Results Compared with Diclofenac Diethylamine Emulgel treatment group, the pain recovery time of QiZheng XiaoTong plaster treatment group is significantly less（8.26 days vs.9.23 days,P〈0.001）.QiZheng XiaoTong plaster treatment group gains more QALYs （0.0362 vs. 0.0359,P = 0.597）,but the cost is higher （308.52 Yuan vs.297.43 Yuan,P = 0.697）.Cost-efectiveness analysis shows that the incremental cost-efectiveness ratio （ICER） is-11.43 Yuan/day,which means that reducing one additional day of pain recovery costs 11.43 Yuan more.Cost-utility analysis shows that the incremental cost-utility ratio（ICUR） was 36,966.67 Yuan/QALY,below the threshold of 115,000 Yuan/QALY suggested by WHO（3 times of GDP per capita）.Conclusion In the treatment of acute lumbar sprain,QiZheng XiaoTong plaster is a highly cost-efective strategy for clinical promotion.