基于Meta分析的复方龙血竭胶囊治疗冠状动脉粥样硬化性心脏病稳定型心绞痛(心血瘀阻证)的药物经济学评价

Pharmacoeconomic Evaluation of Compound Longxuejie Capsule in the Treatment of Stable Angina Pectoris with Coronary Atherosclerotic Heart Disease(Heart Blood Stasis Syndrome) Using Meta-analysis

目的 对复方龙血竭胶囊治疗冠状动脉粥样硬化性心脏病稳定型心绞痛(心血瘀阻证)进行成本-效果分析。方法基于复方龙血竭胶囊治疗冠状动脉粥样硬化性心脏病稳定型心绞痛(心血瘀阻证)的Meta分析获得效果指标。计算复方龙血竭胶囊和复方丹参胶囊治疗冠状动脉粥样硬化性心脏病稳定型心绞痛(心血瘀阻证)的成本-效果比,通过软件Tree Age Pro构建决策树模型进行成本-效果分析和敏感性分析。结果 以心绞痛疗效显效率作为短期疗效参数,用药模拟周期为4周(28 d),结果显示在提高心绞痛疗效显效率方面复方龙血竭胶囊优于复方丹参胶囊,差异有统计学意义(P<0.05);复方龙血竭胶囊的治疗成本高于复方丹参胶囊,而复方龙血竭胶囊相对于复方丹参胶囊的增量成本-效果比为3 046.91元,小于人均可支配收入的10%。敏感性分析结果显示,基础分析结果相对稳健。结论 根据2020年人均可支配收入作为患者意愿支付(WTP)阈值的假设,与复方丹参胶囊相比,复方龙血竭胶囊治疗冠状动脉粥样硬化性心脏病稳定型心绞痛(心血瘀阻证)可能更具有成本-效果优势。

Objective An economic assessment of Compound Longxuejie Capsule was conducted to determine its pharmacoeconomic value in the treatment of stable angina pectoris with coronary atherosclerotic heart disease(heart cardiac blood stasis syndrome).Methods Based on the meta-analysis of compound Longxueji capsule in the treatment of stable angina pectoris with coronary atherosclerotic heart disease(syndrome of blood stasis),the efficacy indicators were obtained.The cost-effectiveness ratio of compound Longxueji capsule and compound Danshen capsule in the treatment of stable angina pectoris with coronary atherosclerotic heart disease(heart cardiac blood stasis syndrome) was calculated,and the decision Tree model was constructed by Tree Age Pro for cost-effectiveness analysis and sensitivity analysis.Results The efficacy of angina pectoris was taken as the short-term efficacy parameter,and the simulation period was 4 weeks(28 d).The results showed that compound Longxuei capsule was better than compound Danshen capsule in improving the efficacy of angina pectoris,and the difference was statistically significant(P<0.05).The treatment cost of compound Dragon's blood exhaust capsule was higher than that of compound Danshen capsule,and the incremental cost-effectiveness ratio of compound Dragon's blood exhaust capsule to compound Danshen capsule was 3 046.91 yuan,which was less than 10% of per capita disposable income.The results of sensitivity analysis show that the results of basic analysis are relatively robust.Conclusion Based on the assumption of per capita disposable income as the patient willing to pay(WTP) threshold in 2020,compound Longxuei capsule may have a cost-effectiveness advantage in the treatment of stable angina pectoris with coronary atherosclerotic heart disease(blood blood stagnation syndrome) compared with compound salvia miltiorrhia capsule.