基于决策树模型的铁剂补充治疗血液透析患者肾性贫血的经济学评价

Economic Evaluation of Iron Supplements for Hemodialysis Patients with Renal Anemia Based on Decision Tree Model

目的评价蔗糖铁注射液、多糖铁胶囊及其他口服铁补充制剂治疗血液透析患者肾性贫血方案的成本-效果,为临床药物选择提供参考。方法通过对肾性贫血临床治疗结果进行单组率Meta分析获得各干预措施的临床治疗有效率,并建立决策树模型对其成本与效果进行经济学评价,并对参数不确定性进行单因素敏感性分析。结果共纳入670例患者进行成本-效果分析。结果显示,在多糖铁胶囊有效率较低的情况下,意愿支付>22590.61元,蔗糖铁静脉注射液具有最好的成本-效果。而在其他口服补铁制剂中,多糖铁胶囊治疗血液透析患者肾性贫血最具经济学效益。结论血液透析患者肾性贫血首选静脉补铁治疗。静脉补铁副作用较大或需长期用药情况下,口服铁剂治疗肾性贫血首选多糖铁胶囊。

Objective To evaluate the cost-effectiveness of different methods of iron supplement for hemodialysis patients with renal anemia,which included iron sucrose injection,polysaccharide-iron complex capsules and other oral iron supplements.Methods Using single-rate meta-analysis for efficacy of all interventions,then building a decision tree model for economic evaluating.And one-way sensitivity analysis was conducted.Results 670 patients were included.When the efficiency of polysaccharide-iron complex capsules were low and willing to pay of patients was higher than￥22590.61,iron sucrose injection could be taken as cost-effective.While among the oral iron supplements,polysaccharide-iron complex was no doubt the best cost-effective choice.Conclusion Optimization for hemodialysis patients with renal anemia was intravenous iron supplements.When the patients could not intolerant with intravenous iron or in a long-term therapy,polysaccharide-iron complex could be taken as the best choice among all the oral iron supplements.