Rare Diseases Research Institute, Instituto de Salud Carlos III, Madrid, Spain.
Community Dent Oral Epidemiol. 2012 Apr;40(2):185-92. doi: 10.1111/j.1600-0528.2011.00645.x. Epub 2011 Nov 1.
To study the cost-effectiveness of four alternative treatments for burning mouth syndrome (BMS).
A cost-effectiveness analysis was conducted from a healthcare payer perspective of four therapy strategies (amisulpride, paroxetine, sertraline and topical clonazepam), using a decision-tree model that incorporated direct healthcare costs and probabilities associated with the possible events and outcomes. Average cost-effectiveness and incremental cost-effectiveness ratios were calculated. Sensitivity analyses included the costs of brand name and generic drugs in five European countries (France, Italy, the Netherlands, Spain and UK), as well as two scenarios with different treatment length.
Of the drugs analysed, topical clonazepam proved to be the most cost-effective therapy. Although generic proved more efficient than brand name drugs, they displayed no advantage over brand name topical clonazepam. The Netherlands was the country with the highest overall drug efficiency. Sensitivity analyses highlighted the robustness of the model, because topical clonazepam proved to be the most efficient therapy under all the different scenarios.
Topical clonazepam, which previous analyses of clinical evidence have shown to be the drug of choice for BMS, also proved to be the most cost-effective of the drugs analysed for this condition.
研究治疗灼口综合征(BMS)的四种替代疗法的成本效益。
从医疗保健支付者的角度出发,采用决策树模型对四种治疗策略(氨磺必利、帕罗西汀、舍曲林和局部氯硝西泮)进行成本效益分析,该模型纳入了与可能事件和结果相关的直接医疗成本和概率。计算平均成本效益和增量成本效益比。敏感性分析包括在五个欧洲国家(法国、意大利、荷兰、西班牙和英国)的品牌和仿制药成本,以及两种不同治疗时长的方案。
在分析的药物中,局部氯硝西泮被证明是最具成本效益的治疗方法。虽然仿制药比品牌药更有效,但与品牌局部氯硝西泮相比,它们没有优势。荷兰是整体药物效率最高的国家。敏感性分析突出了模型的稳健性,因为在所有不同的方案中,局部氯硝西泮均被证明是最有效的治疗方法。
局部氯硝西泮先前的临床证据分析表明是治疗 BMS 的首选药物,对于这种疾病,它也被证明是分析药物中最具成本效益的药物。