目的比较启动降尿酸治疗初期不采用预防措施及采用不同药物预防痛风发作的成本效果。方法本研究采用决策树模型,基于日本FORTUNE-1临床试验和美国IQVIA~(TM)健康计划索赔数据库开展回顾性研究,以3个月为研究时长,选取卫生体系视角,评估...目的比较启动降尿酸治疗初期不采用预防措施及采用不同药物预防痛风发作的成本效果。方法本研究采用决策树模型,基于日本FORTUNE-1临床试验和美国IQVIA~(TM)健康计划索赔数据库开展回顾性研究,以3个月为研究时长,选取卫生体系视角,评估在降尿酸治疗初期不采用预防措施,以及采用小剂量秋水仙碱、小剂量非甾体抗炎药(nonsteroidal antiinflammatory drug,NSAID,以萘普生为例)预防痛风发作的成本效果,以增量成本效果比(incremental cost-effectiveness ratio,ICER)和增量净货币效益(incremental net monetary benefit,INMB)为结果指标。结果基础分析显示,秋水仙碱以55.29元获得0.2480质量调整生命年(quality adjustment of life year,QALY),NSAID以196.96元获得0.2482 QALY,无预防措施以82.41元获得0.2451 QALY。与无预防措施相比,秋水仙碱、NSAID的ICER分别为-9197.73元/QALY(绝对优势)、36514.08元/QALY;秋水仙碱、NSAID的INMB分别为785.35元、691.97元。情境分析结果证实了模型的稳健性。单因素敏感性分析表明,秋水仙碱/NSAID较无预防措施在各参数变化范围内始终具有成本效果优势;在两种预防措施的比较中,NSAID的价格、秋水仙碱引起腹泻的概率对结果影响较大;概率敏感性分析则表明,在当前支付意愿阈值(257094元/QALY),秋水仙碱预防、NSAID、无预防措施可被接受的概率分别为67.6%、3.1%、29.3%。结论在当前经济水平下,降尿酸药物治疗初期,同时使用小剂量秋水仙碱预防痛风急性发作最具经济学效益。展开更多
Nowadays, the governments and worldwide energy and environmental scientists have been focusing on CO2 enhanced coalbed methane recovery （CO2-ECBM） to reduce greenhouse gas emissions and to increment coalbed methane ...Nowadays, the governments and worldwide energy and environmental scientists have been focusing on CO2 enhanced coalbed methane recovery （CO2-ECBM） to reduce greenhouse gas emissions and to increment coalbed methane production. Previous researches have confirmed that CO2 can react with minerals in coal seams to transform the permeability of coal. However, few studies have paid attention to the influence of the reaction of CO2 with minerals on the pore distribution and methane adsorption of coals.展开更多
文摘目的比较启动降尿酸治疗初期不采用预防措施及采用不同药物预防痛风发作的成本效果。方法本研究采用决策树模型,基于日本FORTUNE-1临床试验和美国IQVIA~(TM)健康计划索赔数据库开展回顾性研究,以3个月为研究时长,选取卫生体系视角,评估在降尿酸治疗初期不采用预防措施,以及采用小剂量秋水仙碱、小剂量非甾体抗炎药(nonsteroidal antiinflammatory drug,NSAID,以萘普生为例)预防痛风发作的成本效果,以增量成本效果比(incremental cost-effectiveness ratio,ICER)和增量净货币效益(incremental net monetary benefit,INMB)为结果指标。结果基础分析显示,秋水仙碱以55.29元获得0.2480质量调整生命年(quality adjustment of life year,QALY),NSAID以196.96元获得0.2482 QALY,无预防措施以82.41元获得0.2451 QALY。与无预防措施相比,秋水仙碱、NSAID的ICER分别为-9197.73元/QALY(绝对优势)、36514.08元/QALY;秋水仙碱、NSAID的INMB分别为785.35元、691.97元。情境分析结果证实了模型的稳健性。单因素敏感性分析表明,秋水仙碱/NSAID较无预防措施在各参数变化范围内始终具有成本效果优势;在两种预防措施的比较中,NSAID的价格、秋水仙碱引起腹泻的概率对结果影响较大;概率敏感性分析则表明,在当前支付意愿阈值(257094元/QALY),秋水仙碱预防、NSAID、无预防措施可被接受的概率分别为67.6%、3.1%、29.3%。结论在当前经济水平下,降尿酸药物治疗初期,同时使用小剂量秋水仙碱预防痛风急性发作最具经济学效益。
基金financially supported by the National Natural Science Foundation of China(grant No.41572138)the Fundamental Research Fund for Central University(grant No.2014QNA17)
文摘Nowadays, the governments and worldwide energy and environmental scientists have been focusing on CO2 enhanced coalbed methane recovery （CO2-ECBM） to reduce greenhouse gas emissions and to increment coalbed methane production. Previous researches have confirmed that CO2 can react with minerals in coal seams to transform the permeability of coal. However, few studies have paid attention to the influence of the reaction of CO2 with minerals on the pore distribution and methane adsorption of coals.
