基于决策树模型的口服铁补充制剂治疗妊娠期缺铁性贫血的成本效果分析

Cost-effectiveness analysis of oral iron supplements of iron-deficiency anemia in pregnancy based on decision tree

目的:应用药物经济学评价方法,对我国临床常用的多糖铁胶囊、琥珀酸亚铁片、生血宁片、硫酸亚铁片、复方硫酸亚铁叶酸片5种药品治疗妊娠期缺铁性贫血进行成本效果分析,为临床合理用药提供参考和建议。方法:通过建立决策树模型,对网状Meta分析获得的治疗有效率进行成本效果分析,并且对参数的不确定性进行敏感性分析。结果:成本效果分析显示,从增量成本效果比(incremental cost effectiveness ratio,ICER)来看,生血宁片、复方硫酸亚铁叶酸片为绝对劣势策略,多糖铁胶囊相比硫酸亚铁片每提升一个效果所增加成本为2 050. 00元。敏感性分析结果与基础分析结果保持一致,多糖铁胶囊的成本变化不会对现有结论产生影响。结论:临床上可以根据患者的支付意愿对妊娠期缺铁性贫血进行推荐用药。在每个效果支付意愿高于2 050. 00元时,临床上可以推荐有效率更高、不良反应率更低的多糖铁胶囊作为首选用药。

Objective:To evaluate the cost-effectiveness of five commonly used oral iron supplements,including Iron Polysaccharide Complex Capsules,Ferrous Succinate Tablets,Shengxuening Tablets,Ferrous Sulfate Tablets,Compound Ferrous Sulfate And Folic Acid Tablets,for iron-deficiency anemia in pregnancy using pharmacoeconomical method and provide reference for the clinical choice.Methods:The decision tree model was applied to analyze the cost-effectiveness of the effective rates obtained from network meta-analysis,and one-way sensitivity analysis and probabilistic sensitivity analysis were also conducted.Results:the incremental cost effectiveness ratio(ICER)showed that Shengxuening Tablets were excluded as the absolutely dominated strategy.Compared with Ferrous Sulfate Tablets,the increased cost of Iron Polysaccharide Complex Capsules was$2 050.00.The result of sensitivity analyses was consistent with fundamental analysis and the variability of the cost of Iron Polysaccharide Complex Capsules would not make a difference to the results.Conclusion:Clinicians may make optimal decision according to the willingness-to-pay(WTP)of different patients.When WTP>$2 050.00,Iron Polysaccharide Complex Capsules could be the reference drug because of its higher effective rates and lower adverse reaction rates.