ω-3脂肪酸补充剂在中国接受肠外营养的重症监护病房患者中的成本效益
Cost and effectiveness of omega-3 fatty acid supplementation in Chinese ICU patients receiving parenteral nutrition.
作者信息
Wu Guo Hao, Gao Jian, Ji Chun Yan, Pradelli Lorenzo, Xi Qiu Lei, Zhuang Qiu Lin
机构信息
Department of General Surgery, Fudan University, Shanghai, People's Republic of China.
Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
出版信息
Clinicoecon Outcomes Res. 2015 Jun 26;7:369-75. doi: 10.2147/CEOR.S81277. eCollection 2015.
BACKGROUND AND OBJECTIVES
Clinical evidence supports the use of omega-3 polyunsaturated fatty acid (PUFA)-enriched lipid emulsions in place of standard lipid emulsions in parenteral nutrition (PN) for intensive care unit (ICU) patients, but uptake may be limited by higher costs. We compared clinical and economic outcomes for these two types of lipid emulsion in the Chinese ICU setting.
METHODS
We developed a pharmacoeconomic discrete event simulation model, based on efficacy data from an international meta-analysis and patient characteristics, resource consumption, and unit costs from a Chinese institutional setting. Probabilistic sensitivity analyses were undertaken to assess the effects of uncertainty around input parameters. Model predictive validity was assessed by comparing results with data observed in a patient subset not used in the modeling.
RESULTS
The model predicted that omega-3 PUFA-enriched emulsion (Omegaven(®) 10% fish oil emulsion) would dominate standard lipid emulsions, with better clinical outcomes and lower overall health care costs (mean savings ~10,000 RMB), mainly as a result of faster recovery and shorter hospital stay (by ~6.5 days). The external validation process confirmed the reliability of the model predictions.
CONCLUSION
Omega-3 PUFA-enriched lipid emulsions improved clinical outcome and decreased overall costs in Chinese ICU patients requiring PN.
背景与目的
临床证据支持在重症监护病房（ICU）患者的肠外营养（PN）中使用富含ω-3多不饱和脂肪酸（PUFA）的脂质乳剂替代标准脂质乳剂，但采用率可能受到较高成本的限制。我们在中国ICU环境中比较了这两种脂质乳剂的临床和经济结果。
方法
我们基于一项国际荟萃分析的疗效数据以及中国机构环境中的患者特征、资源消耗和单位成本，开发了一个药物经济学离散事件模拟模型。进行概率敏感性分析以评估输入参数不确定性的影响。通过将结果与未用于建模的患者亚组中观察到的数据进行比较来评估模型预测有效性。
结果
该模型预测，富含ω-3 PUFA的乳剂（Omegaven® 10%鱼油乳剂）将优于标准脂质乳剂，具有更好的临床结果和更低的总体医疗保健成本（平均节省约10,000元人民币），主要是由于恢复更快和住院时间缩短（约6.5天）。外部验证过程证实了模型预测的可靠性。
结论
富含ω-3 PUFA的脂质乳剂改善了需要PN的中国ICU患者的临床结果并降低了总体成本。
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