5种方案预防性治疗偏头痛的成本-效果分析

Cost effectiveness analysis of 5 treatment options for migraine prevention

目的探讨5种方案预防性治疗偏头痛的临床疗效,并进行药物经济学分析,为预防性治疗偏头痛提供经济、合理的治疗方案。方法采用回顾性研究方法,将200例偏头痛患者随机分为美托洛尔组(A组)、氟桂利嗪组(B组)、美托洛尔+氟桂利嗪组(C组)、头痛宁胶囊组(D组)、都梁软胶囊组(E组),每组各40例。采用成本-效果分析法并引入决策树模型,对5种治疗方案进行药物经济学评价。结果 A、B、C、D、E组的有效率分别为60.00%、72.50%、95.00%、45.00%、22.50%,总治疗成本分别为756.48、765.26、731.98、857.17、874.46元,成本-效果比(C/E)分别为12.61、10.56、7.71、19.05、38.86。其中,C组治疗方案的成本-效果比(C/E)最小,最具经济性。敏感性分析结果与最小成本分析结果相一致。结论在上述5种偏头痛预防性治疗方案中,美托洛尔+氟桂利嗪预防性治疗偏头痛更具成本-效果优势,是预防偏头痛较佳的治疗方案。

Objective To observe the clinical efficacies and to conduct the cost-effectiveness analysis of five kinds of preventive therapeutic schedule for Migraine,in order to provide reference for economic and reasonable preventive treatment programmes for migraine.Methods By retrospective study,400 patients with migraine were randomly divided into groups A（metoprolol）,B（flunarizine）,C（metoprolol ＋ flunarizine）,D（Toutongning Capsule） and E（Duliang Soft Capsule） by using the table of random numbers,according to different therapy regimens.There were 40 cases in each group,and they were given corresponding treatments,respectively.All the patients were treated for 5weeks.The pharmacoeconomics of therapy regimens in group A,B,C,D and E were evaluated by cost-effectiveness analysis and decision tree analysis model.Results The effective rates of groups A,B,C,D and E were 60.00%, 72.50%, 95.00%, 45.00% and 22.50%, respectively. The treatment cost of those groups were 756.48, 765.26, 731.98, 857.17, 874.46 yuan,respectively.The cost/effectiveness（C/E）ratios of those groups were 12.61, 10.56, 7.71, 19.05, 38.86, respectively.The cost/effectiveness（C/E）ratios of group C was the smallest,which meant the therapy regimen C was the most economic one.Sensitivity analysis had the same result as the cost-effectiveness analysis.Conclusion C group（metoprolol ＋ flunarizine） is the best one among 5 kinds of preventive treatment programme for migraine in respect of cost-effectiveness.