气滞胃痛颗粒治疗功能性消化不良的系统评价与药物经济学研究

Systematic review and pharmacoeconomic evaluation of Qizhi Weitong Granules in treatment of functional dyspepsia

该研究旨在评价气滞胃痛颗粒治疗功能性消化不良的有效性、安全性与经济性。选取临床常用的治疗功能性消化不良方案:气滞胃痛颗粒+莫沙必利片vs单用莫沙必利片,基于已发表的临床研究进行Meta分析,评价治疗的有效性、安全性,并以Meta分析结果作为效果进行药物经济学评价。采用成本-效果手段对增量成本-效果比(ICER)进行分析,并通过旋风图、蒙特卡洛模拟进行敏感性分析。通过调研功能性消化不良患者,确定该病的意愿支付阈值,并与ICER对比,从对气滞胃痛颗粒的经济性进行评价。基础分析结果显示,气滞胃痛颗粒+莫沙必利片治疗功能性消化不良有效率为95.49%,高于单用莫沙必利片(73.30%)(OR=8.52,95%CI[4.36,16.64]),具有显著性差异(P<0.0001)。安全性方面,2组无显著性差异。气滞胃痛颗粒+莫沙必利片价格相较于单用莫沙必利片更高,ICER为640.29元,但低于患者意愿支付阈值1506.67元,敏感性分析显示结果较为稳健。综上,气滞胃痛颗粒+莫沙必利片治疗功能性消化不良安全且更加有效、经济,临床值得推广。

This study aims to investigate the efficacy,safety,and cost-effecctiveness of Qizhi Weitong Granules in the treatment of functional dyspepsia.Specifically,two commonly used clinical protocols for the treatment of functional dyspepsia were selected:Qizhi Weitong Granules+Mosapride vs Mosapride alone(control).Meta-analysis of previous clinical studies was performed to examine the efficacy and safety,and pharmacoeconomic evaluation was carried out according to the results of the Meta-analysis.The cost-effectiveness analysis was carried out to elucidated the incremental cost-effectiveness ratio(ICER),and the sensitivity was analyzed with tornado dia-gram and Monte Carlo simulation.The willingness-to-pay threshold of patients for functional dyspepsia was investigated and compared with the ICER to evaluate whether Qizhi Weitong Granules was cost-effective.The result showed that the effective rate of Qizhi Weitong Granules combined with Mosapride in the treatment of functional dyspepsia was 95.49%,which was higher than that of Mosapride alone(73.30%)(OR=8.52,95%CI[4.36,16.64])(P<0.0001).The two groups showed no significant difference in safety.The price of Qizhi Weitong Granules+Mosapride was higher than that of Mosapride alone.The ICER was 640.29 CNY,1506.67 CNY lower than the willingness-to-pay threshold.The sensitivity analysis showed that the analysis results were relatively stable.Thus,Qizhi Weitong Granules+Mosapride is safe,effective,and economical in the treatment of functional dyspepsia,which should be further promoted in clinical settings.