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评估约克粪便钙卫蛋白护理路径的成本效用。

Evaluation of the Cost-Utility of the York Faecal Calprotectin Care Pathway.

机构信息

York Health Economics Consortium, York, UK.

Yorkshire and Humber Academic Health Science Network, Wakefield, UK.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2022 Apr;22(3):521-528. doi: 10.1080/14737167.2020.1751613. Epub 2020 Apr 19.

Abstract

: Lower gastrointestinal symptoms are common in the general population and it can be difficult to discriminate between inflammatory bowel disease (IBS) and irritable bowel syndrome (IBD) due to overlap of symptoms. The York Fecal Calprotectin Care Pathway (YFCCP) was introduced in 2016 as an alternative to the NICE fecal calprotectin pathway (DG11). This analysis uses the prospective data from the first 1005 patients in the YFCCP. Previous analysis demonstrated the YFCCP may be cost-saving when compared with the DG11 pathway. This analysis examined the short-term health-related quality of life (HRQoL) impact for patients in the YFCCP for IBD and IBS.: A decision tree model was used to estimate the proportion of people presenting with lower gastrointestinal symptoms that were correctly or falsely diagnosed with IBS and IBD. Time to diagnosis data was estimated and HRQoL data was estimated from published sources. Costs and QALYs were calculated for the YFCCP and each comparator.: The YFCCP was cost-effective at a £20,000 threshold when compared with the current NICE recommended pathways and was cost-saving with a QALY gain (dominant)in four of the five comparators. Conclusions: The YFCCP demonstrated a QALY benefit when compared with all alternative pathways.

摘要

下胃肠道症状在普通人群中很常见,由于症状重叠,很难将炎症性肠病(IBD)和肠易激综合征(IBS)区分开来。2016 年,引入了约克粪便钙卫蛋白护理途径(YFCCP)作为替代 NICE 粪便钙卫蛋白途径(DG11)的方法。本分析使用了 YFCCP 中前 1005 名患者的前瞻性数据。先前的分析表明,与 DG11 途径相比,YFCCP 可能具有成本效益。本分析检查了 YFCCP 中 IBD 和 IBS 患者的短期健康相关生活质量(HRQoL)影响。使用决策树模型估计以下情况的比例:以 IBS 和 IBD 正确或错误诊断的下胃肠道症状患者。估计诊断时间数据,并从已发表的来源估计 HRQoL 数据。为 YFCCP 和每个比较器计算成本和 QALYs。在 20000 英镑的阈值下,YFCCP 与当前 NICE 推荐的途径相比具有成本效益,并且在五个比较器中的四个中具有 QALY 增益(占主导地位)。结论:与所有替代途径相比,YFCCP 显示出 QALY 获益。

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