连花清瘟胶囊治疗成人流行性感冒的有效性与安全性及经济性评价

Efficacy,Safety and Economic Evaluation of Lianhua Qingwen Capsule in the Treatment of Adult Influenza

目的比较连花清瘟胶囊、连花清瘟胶囊联合磷酸奥司他韦胶囊以及磷酸奥司他韦胶囊治疗成人流行性感冒的临床有效性、安全性及经济性。方法通过检索中英文数据库,纳入连花清瘟胶囊或连花清瘟胶囊联合磷酸奥司他韦胶囊治疗成人流行性感冒的随机对照试验(RCT)。以磷酸奥司他韦胶囊为共同对照,通过网状Meta分析比较连花清瘟胶囊和连花清瘟胶囊联合磷酸奥司他韦胶囊治疗成人流行性感冒的有效性和安全性。通过成本-效果分析进行经济性评价。结果本研究纳入22篇文献,共计2323例患者。网状Meta分析结果显示在有效性方面,磷酸奥司他韦胶囊方案、连花清瘟胶囊方案与连花清瘟胶囊联合磷酸奥司他韦胶囊方案的临床总有效率分别为84.0%、89.2%、99.0%。成本-效果分析结果显示,磷酸奥司他韦胶囊方案、连花清瘟胶囊方案与连花清瘟胶囊联合磷酸奥司他韦胶囊方案的疗程总成本分别为96.7元、29.4元和126.1元。与连花清瘟胶囊方案相比,磷酸奥司他韦胶囊方案为绝对劣势;连花清瘟胶囊联合磷酸奥司他韦胶囊方案与连花清瘟胶囊方案相比每多使一例患者达到临床有效,需要多花费986.7元。当意愿支付值为1050元时,连花清瘟胶囊具有经济性的概率为58.1%;当意愿支付值为3500元时,连花清瘟胶囊联合磷酸奥司他韦胶囊具有经济性的概率为90.7%。结论连花清瘟胶囊、连花清瘟胶囊联合磷酸奥司他韦胶囊的有效率均大于磷酸奥司他韦胶囊单用。当意愿支付值较低时,单用连花清瘟胶囊可能更具经济性;随着意愿支付值的增加,连花清瘟胶囊联合磷酸奥司他韦胶囊可能更具经济性。

Objective To compare the clinical efficacy,safety and economy of Lianhua Qingwen capsule,Lianhua Qingwen capsule combined with Oseltamivir Phosphate capsule and oseltamivir phosphate capsule in the treatment of adult influenza.Methods Randomized controlled trials of Lianhua Qingwen capsule or Lianhua Qingwen capsule combined with Oseltamivir Phosphate capsule in the treatment of adult influenza was included by searching the Chinese and English databases.The efficacy and safety of Lianhua Qingwen capsule alone and Lianhua Qingwen Capsule combined with Oseltamivir Phosphate capsule in the treatment of adult influenza were compared with Oseltamivir Phosphate capsule as the control through network meta-analysis(NWM).Economic evaluation was conducted through cost-effectiveness analysis.Results 22 articles were included in this study,including 2323 patients.The results of NWM showed that in terms of effectiveness,the effective rates of Oseltamivir Phosphate capsule scheme,Lianhua Qingwen capsule scheme and Lianhua Qingwen capsule combined with Oseltamivir Phosphate capsule scheme were 84.0%,89.20%and 99.00%respectively.The cost-effectiveness analysis results show that the total cost of Oseltamivir Phosphate capsule scheme,Lianhua Qingwen capsule scheme and Lianhua Qingwen capsule combined with Oseltamivir Phosphate capsule scheme are 96.7 yuan,29.4 yuan and 126.1 yuan respectively.Compared with Lianhua Qingwen capsule alone,Oseltamivir Phosphate capsule scheme is an absolute disadvantage.Compared with Lianhua Qingwen capsule alone,the scheme of Lianhua Qingwen capsule combined with Oseltamivir Phosphate capsule costs 986.7 yuan more to make one more patient reach clinical effectiveness.When the willing payment value is 1050 yuan,the economic probability of Lianhua Qingwen capsule is 58.1%.When the willing payment value is 3500 yuan,the economic probability of Lianhua Qingwen capsule combined with Oseltamivir Phosphate capsule is 90.7%.Conclusion The effective rate of Lianhua Qingwen capsule and Lianhua Qingwen capsule combined with oseltamivir phosphate capsule was higher than that of oseltamivir phosphate capsule alone.When the willingness to pay is low,Lianhua Qingwen capsule alone may be more economical.With the increase of willingness to pay,Lianhua Qingwen capsule combined with oseltamivir phosphate capsule may be more economical.