基于Meta分析的止喘灵口服液治疗支气管哮喘(寒证、热证)的药物经济学评价

Pharmacoeconomic Evaluation of Zhichuanling Oral Liquid in the Treatment of Bronchial Asthma(Cold Syndrome and Heat Syndrome)Based on Meta-Analysis

目的:从卫生体系的角度,评价止喘灵口服液治疗支气管哮喘(寒证、热证)的经济性。方法:系统梳理截至2023年4月各大数据库中关于止喘灵口服液治疗支气管哮喘的随机对照试验(对照组患者为西医常规治疗,观察组患者在对照组基础上加用止喘灵口服液),使用RevMan 5.4软件进行Meta分析。基于Meta分析的结果构建决策树模型,采用成本-效果分析方法,回顾性评价止喘灵口服液联合西医常规治疗方案治疗支气管哮喘(寒证、热证)的经济性。结果:共纳入6篇符合标准的文献进行Meta分析,结果表明,相较于对照组治疗方案,观察组方案治疗支气管哮喘(寒证、热证)的疗效更优。基于Meta分析结果进行成本-效果分析后发现,观察组治疗方案的成本参数为8869.41元,效果参数(总有效率)为95.88%;对照组治疗方案的成本参数为8777.01元,效果参数为77.25%。进一步计算得出其增量成本为92.40元,增量效果为18.63%,增量成本-效果比为495.97元/%。单因素敏感性分析表明,支气管哮喘治疗的平均费用对研究结果影响最大;概率敏感性分析表明,该研究结果相对稳健。结论:对于支气管哮喘(寒证、热证)患者,相较于单纯使用西医常规治疗方案,在常规治疗方案的基础上联合应用止喘灵口服液的经济性更好。

OBJECTIVE:To evaluate the economy of Zhichuanling oral liquid in the treatment of bronchial asthma(cold syndrome and heat syndrome)from the perspective of health system.METHODS:Randomized controlled trials of Zhichuanling oral liquid in the treatment of bronchial asthma(the control group was treated with conventional Western medicine,while the observation group was treated with Zhichuanling oral liquid added to the control group)in major databases until Apr.2023 were systematically reviewed,and Meta-analysis was performed by using RevMan 5.4 software.A decision tree model was constructed based on results of Meta-analysis,and cost-effectiveness analysis was used to retrospectively evaluate the economics of Zhichuanling oral liquid combined with conventional treatment regimens in the treatment of bronchial asthma(cold syndrome and heat syndrome).RESULTS:A total of 6 literature meeting the criteria were included for Meta-analysis,and the results indicate that compared to the control group,the observation group showed superior efficacy in treating bronchial asthma(cold syndrome,heat syndrome).Basing on the results of Meta-analysis,we conducted the cost-effectiveness analysis and the results revealed that the cost parameter of observation group was 8869.41 yuan with the effect parameter(total effective rate)was 95.88%.and the cost parameter of the control group was 8777.01 yuan with the effect parameter was 77.25%.Then we further calculated to have an incremental cost of 92.40 yuan,an incremental effect of 18.63%,and an incremental cost-effect ratio of 495.97 yuan/%.Single factor sensitivity analysis showed that the average cost of bronchial asthma treatment had the greatest influence on the results of the study.Probability sensitivity analysis showed stable results.CONCLUSIONS:For patients with bronchial asthma(cold syndrome and heat syndrome),compared with conventional treatment,Zhichuanling oral liquid combined with conventional treatment is more economical.