West China School of Pharmacy Sichuan University, 17, Renmin South Road, 3rd Section, Chengdu, 610041, Sichuan, China.
Division of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of Cincinnati Medical Center, Cincinnati, OH, USA.
BMC Complement Med Ther. 2020 Nov 5;20(1):330. doi: 10.1186/s12906-020-03091-3.
We evaluated the long-term cost-effectiveness of antihypertensive traditional Chinese medicines (TCMs) and to compare the cost-effectiveness of a combined treatment consisting of compound Apocynum tablets and Nifedipine sustained-release tablets with the cost-effectiveness of treatment with Nifedipine sustained-release tablets alone.
A Markov model was used to simulate the potential incremental cost-effectiveness per quality-adjusted life year (QALY) to be gained from compound Apocynum tablets and Nifedipine sustained-release tablets compared with Nifedipine sustained-release tablets alone. Model parameter estimates were informed by previously published studies. The direct medical costs of outpatients with hypertension were estimated from the health care provider's perspective. A 5% annual discount rate was applied to both costs and QALYs.
TCMs combined with Nifedipine sustained-release tablets group generated a total 20-year cost of 11,517.94 RMB (US $1739.87), whereas Nifedipine sustained-release tablets alone group resulted in a 20-year cost of 7253.71 RMB (US $1095.73). TCMs combined with Nifedipine sustained-release tablets group resulted in a generation of 12.69 QALYs, whereas Nifedipine sustained-release tablets alone group resulted in 12.50. The incremental cost-utility ratio was 22,443.32 RMB (US $3390.23) per QALY. Considering the threshold of 1 GDP per capita in China in 2018 (US $9764.95), the combination of compound Apocynum tablets and Nifedipine sustained-release tablets was a cost-effective strategy. One-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range.
Combining Traditional Chinese Medicines with chemical medicines is more cost-effective strategy in the treatment of hypertension.
本研究旨在评估降压中药的长期成本效果，并比较复方罗布麻片联合硝苯地平控释片的综合治疗方案与硝苯地平控释片单药治疗方案的成本效果。
采用 Markov 模型模拟复方罗布麻片联合硝苯地平控释片相对于硝苯地平控释片单药治疗的潜在增量成本效果比（每增加一个质量调整生命年的成本）。模型参数估计值来源于已发表的研究。从医疗服务提供者的角度估算高血压门诊患者的直接医疗成本。成本和质量调整生命年均采用 5%的贴现率。
与硝苯地平控释片单药治疗组相比，中药联合硝苯地平控释片组在 20 年内的总费用为 11517.94 元人民币（1739.87 美元），而硝苯地平控释片单药治疗组在 20 年内的总费用为 7253.71 元人民币（1095.73 美元）。中药联合硝苯地平控释片组的质量调整生命年为 12.69，硝苯地平控释片单药治疗组的质量调整生命年为 12.50。增量成本效果比为 22443.32 元人民币（3390.23 美元）/质量调整生命年。考虑到 2018 年中国人均国内生产总值（9764.95 美元）的阈值，复方罗布麻片联合硝苯地平控释片是一种具有成本效益的策略。单因素敏感性分析和概率敏感性分析结果均在可接受范围内。
中药联合化学药物治疗高血压的成本效果优于化学药物单药治疗。
