盐酸氟桂利嗪胶囊联合养血清脑颗粒治疗偏头痛经济学评价

Economic Evaluation of Flunarizine Hydrochloride Capsules Combined with Yangxueqingnao Granules in the Treatment of Migraine

目的评价盐酸氟桂利嗪胶囊联合养血清脑颗粒治疗偏头痛的有效性和经济性。方法通过Meta分析,评价盐酸氟桂利嗪胶囊联合养血清脑颗粒(试验组)与盐酸氟桂利嗪胶囊(对照组)治疗偏头痛的有效性。构建决策树模型,对2种方案进行成本-效果分析,并通过成本和有效率分别上下浮动15%对经济性评价结果进行敏感性分析。结果Meta分析总共纳入18篇文献,试验组的临床总有效率优于对照组[RR=1.24,95%CI(1.19,1.29),P<0.00001]。两组患者在用药过程中均未出现严重药品不良反应。试验组成本-效果比(CER)为235.81元,试验组相对于对照组的增量成本-效果比(ICER)为1045.00元。即当支付意愿不超过1045.00元时,最优方案为单用盐酸氟桂利嗪胶囊;当支付意愿大于1045.00元时,最优方案为联合用药;敏感性分析表明,成本-效果分析结果稳健。结论联用盐酸氟桂利嗪胶囊和养血清脑颗粒治疗偏头痛的临床疗效优于单用盐酸氟桂利嗪胶囊,且安全性良好,医师可根据患者支付意愿选择是否采用联合用药。

Objective To evaluate the efficacy and cost-effectiveness of Flunarizine Hydrochloride Capsules combined with Yangxueqingnao Granules in the treatment of migraine.Methods A Meta-analysis was performed to evaluate the efficacy of Flunarizine Hydrochloride Capsules combined with Yangxueqingnao Granules(the experiment group)versus Flunarizine Hydrochloride Capsules(the control group)in the treatment of migraine.A decision tree model was constructed to analyze the cost-effectiveness of the two therapies,and the sensitivity analysis of the economic evaluation results was carried out by the fluctuation of 15%in cost and efficiency respectively.Results A total of 18 articles were included in the Meta-analysis,and the total clinical effective rate of the experimental group was better than that of the control group[RR=1.24,95%CI(1.19,1.29),P<0.00001].No serious adverse drug reactions were found in both groups during the medication administration process.The cost-effectiveness ratio(CER)of experiment group was 235.81 Yuan and the incremental cost-effectiveness ratio(ICER)of the experiment group compared with the control group was 1045.00 Yuan,namely when the willingness to pay(WTP)≤1045.00 Yuan,the optimal scheme was Flunarizine Hydrochloride Capsules alone,and when the WTP>1045.00 Yuan,the optimal scheme was the combination therapy.Sensitivity analysis shows that the cost-effectiveness analysis results were robust.Conclusion The clinical efficacy of Flunarizine Hydrochloride Capsules combined with Yangxueqingnao Granules in the treatment of migraine is better than that of Flunarizine Hydrochloride Capsules alone,and the safety is good.Doctors can choose whether to apply the combination therapy according to the patient’s WTP.