透明质酸钠和硫酸氨基葡萄糖治疗成人大骨节病的成本-效果分析

Cost-effectiveness analysis on hyaluronic acid and glucosamine sulfate treatment for adults with Kaschin-Beck disease

目的对透明质酸钠和硫酸氨基葡萄糖治疗成人大骨节病的成本-效果分析,寻找出价格低、疗效好的治疗方案。方法以治疗产生的费用作为直接成本,依据2011年《大骨节病治疗效果判断》中的关节功能障碍指数综合评分方法,将膝关节改善率作为效果,进行成本-效果分析、增量成本-效果分析及敏感度分析。结果透明质酸钠治疗6个月的关节功能改善率维持在80%-85.7%,硫酸氨基葡萄糖的关节功能改善率维持在58.3%-70.8%;治疗6个月后透明质酸钠和硫酸氨基葡萄糖的成本效果比分别是10.75和23.45;透明质酸钠相对于硫酸氨基葡萄糖的增量成本效果比-34.94;敏感度分析显示成本-效果比及增量成本-效果比对药物价格下降15%不敏感。结论透明质酸钠治疗大骨节病是一种价格低、效果好的治疗方案,硫酸氨基葡萄糖可作为辅助治疗。

Objective To find out a low price,well curative effect treatment for Kaschin-Beck disease（ KBD） by the cost-effectiveness analysis on hyaluronic acid and glucosamine sulfate treatment for adults KBD. Methods The cost of treatment was taken as the direct costs,the therapeutic effect of hyaluronic and glucosamine sulfate for adults KBD were evaluated by the Assessment for therapeutic efficacy on Kaschin-Beck disease in 2011. The cost-effectiveness analysis,the incremental cost-effectiveness and sensitivity analysis were carried out. Results The improvement rate of joint dysfunction index were 80% - 85. 7% after intra- articular hyaluronic acid in 6 months. The improvement rate were 62. 5% - 70. 8% taking glucosamine sulfate in 6months. The cost-effectiveness ratio of hyaluronic acid group and glucosamine sulfate group were 10. 75 and 23. 45 respectively.The incremental cost-effectiveness of hyaluronate acid is-34. 94 comparing to glucosamine sulfate group. Sensitivity analysis showed that the cost-effect and the incremental cost-effect were not sensitive with the drug prices fell by 15%. Conclusion Intra-articular hyaluronic acid were a low price,good curative effect treatment for adults KBD,considering glucosamine sulfate as an auxiliary treatment.