摘要
目的依据《中国药物经济学评价指南(2020中英双语版)》,对布拉氏酵母菌散治疗儿童急性腹泻进行经济学评价。方法从医保和全社会两个角度,构建决策树模型,研究布拉氏酵母菌散相对安慰剂在治疗儿童急性腹泻时的成本效果与成本效用。本研究成本主要数据来源于2020年9月至12月在温州医科大学附属第二医院调研的221份问卷,效果指标为治愈天数,其来自事先开展的一项meta研究,效用指标为质量调整生命年(quality-adjusted life years,QALYs),其效用值来自于发表文献。结果成本效果分析结果显示,在医保支付方角度,布拉氏酵母菌散相对安慰剂平均每天要多花费7.81元,累计成本多14.00元,但使用布拉氏酵母菌散能显著缩短患儿的腹泻时间(平均缩短2.63 d),平均每缩短1 d治疗时间需要多花费5.33元。在全社会角度下,布拉氏酵母菌散平均每天要多花费79.49元,累计成本多花费53.20元,平均每缩短1 d治疗时间需要多花费20.25元。成本效用分析结果显示,在医保角度下,布拉氏酵母菌散相对于安慰剂的增量成本效用比(incremental cost-utility ratio,ICUR)是9380.37元/QALYs,<72447元(中国2020年人均GDP)。在全社会角度下,布拉氏酵母菌散与安慰剂相比较,得到的ICUR值为35645.57元/QALYs,<72447元。单因素敏感性分析结果显示,在医保角度下,成本效用分析的结果没有产生翻转。在全社会角度下,当使用布拉氏酵母菌散初次治疗有效率≤87.5%时,可能使模型结果发生翻转。概率敏感性分析结果显示,预设意愿支付值为1倍人均GDP(72447元)情况下,在医保角度下,布拉氏酵母菌散相对安慰剂组具有经济性的可能性为89%;在全社会角度下,布拉氏酵母菌散相对安慰剂组具有经济性的可能性为73.93%。结论从医保角度和全社会角度出发,在中国2020年1倍人均GDP为意愿支付值的前提下,布拉氏酵母菌散对比安慰剂治疗儿童急
Objective To conduct economic evaluations of Saccharomyces boulardii sachets for treating children with acute diarrhea according to the"Guidelines for the Evaluation Pharmacoeconomics in China(2020 Chinese-English bilingual edition)".Methods From the perspectives of both insurance payer and society,the study assessed the costeffectiveness and cost-utility of Saccharomyces boulardii sachets versus placebo in the treatment of children with acute diarrhea according to decision tree model.The cost data of this study came from 221 questionnaires in the second affiliated hospital of Wenzhou university from September to December 2020.The effect index was cure days,which came from a meta study carried out in advance.The utility index was QALYs,and its utility value came from published literature.Results Costeffectiveness analysis(CEA)showed that from the perspective of insurance payer,Saccharomyces boulardii sachets cost an average of 7.81 Yuan per day(cumulative costs 14.00 yuan)to cure the children compared with the placebo group,but the use of Saccharomyces boulardii sachets can significantly shorten the diarrhea time by an average of 2.63 days.On average,each day shortening the time to cure acute diarrhea will cost 5.33 Yuan more.From the perspective of the society,such the numbers were 79.49 Yuan(53.20 Yuan in total),and will take an extra 20.25 yuan to shorten the time per day.Cost-utility analysis(CUA)indicated that from the perspective of insurance payer,compared with placebo,Saccharomyces boulardii sachets's incremental cost-utility ratio,ICUR is 9380.37 Yuan/QALYs which was much less than 72447 yuan(China's per capita GDP in 2020).From the perspective of society,the ICUR was 35645.57 Yuan/QALYs.One-way sensitivity analysis suggested that the results of CUA have been robust from the perspective of insurance payer.On the other hand,when the cure rate of the first treatment with Saccharomyces boulardii sachets was less than or equal to 87.5%,the model results might be reversed from the perspective of society.Proba
作者
黄开宇
徐奕
陶崴
林小春
王应龙
张田甜
王沛
HUANG Kaiyu;XU Yi;TAO Wai;LIN Xiaochun;WANG Yinglong;ZHANG Tiantian;WANG Pei(Department of Pediatric Gastroenterology,The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang Province,China;Department of Population and Public Health Sciences,Keck School of Medicine of USC University of Southern California,Los Angeles 90033,USA;Hangzhou AIMed Technology Co.,Ltd.,Hangzhou 310051,Zhejiang Province,China;Utrecht University,Utrecht 3584,Netherlands;School of pharmacy,Jinan University,Guangzhou 511436,Guangdong Province,China;School of Public Health,Fudan University,Shanghai 200032,China)
出处
《世界临床药物》
2021年第12期1124-1134,共11页
World Clinical Drug
