麝香保心丸与速效救心丸治疗冠状动脉粥样硬化性心脏病心绞痛的药物经济学评价

A Pharmacoeconomic Evaluation of Shexiang Baoxin Pill Versus Suxiao Jiuxin Pill in the Treatment Coronary Heart Disease

目的评价麝香保心丸与速效救心丸治疗冠状动脉粥样硬化性心脏病心绞痛的疗效和经济性。方法通过检索已发表的麝香保心丸与速效救心丸治疗冠状动脉粥样硬化性心脏病心绞痛的随机对照试验(RCT)文献,进行质量评价和荟萃分析,并结合各省市区的药物价格进行成本-效果比分析。结果共纳入了9篇文献。麝香保心丸相对于速效救心丸在症状有效率方面差异为2%,95%CI(-3%~6%),在心电图有效率方面差异为20%,95%CI(-9%~48%)。全国平均水平下,麝香保心丸的增量成本-效果比为-211.50(改善临床症状)和-40.29(改善心电图结果)。在全国大部分省市区,麝香保心丸改善临床症状、心电图结果方面的增量成本-效果比均为负值,即使在增量成本-效果比为正值的省市区,其数值也相对较低。结论麝香保心丸相对于速效救心丸在改善冠状动脉粥样硬化性心脏病心绞痛患者的症状和心电图结果方面表现更佳,并且在经济性方面具有优势。

Objective To evaluate the efficacy and economy of Shexiang Baoxin Pill and Suxiao Jiuxin Pill in treating coronary heart disease.Methods The literature published on randomized controlled trials(RCTs) of Shexiang Baoxin Pill(treatment group) and Suxiao Jiuxin Pill(control group) in the treatment of coronary heart disease were included.After screening the literature and performing the quality evaluation,RevMan 5.4 software was used for Meta-analysis,and pharmacoeconomic evaluation was performed based on the results of this analysis.Results A total of 9 literatures were included.The difference between Shexiang heart-saving pill and quick-acting heart-saving pill was 2%,95%CI(-3%~6%) in symptom response rate and 20%,95%CI(-9%~48%) in ECG response rate.Under the national average,the incremental cost-effectiveness ratio of Shexiang heart-saving pills was-211.50(improved clinical symptoms) and-40.29(improved ECG results).In most provinces and cities across the country of China,the incremental cost-effectiveness ratio of Shexiang Bao Xin Pill to improve clinical symptoms and electrocardiogram results is negative,and even in provinces and cities across the country with positive incremental cost-effectiveness ratio,the value is relatively low.Conclusion Shexiang Baoxin Pill is more effective than Suxiao Jiuxin Pill in improving symptoms and ECG results in patients with coronary angina.On average across the country,Shexiang Baoxin Pill has the absolute economic advantage over Suxiao Jiuxin Pill.