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蔗糖八硫酸酯敷料治疗 2 型糖尿病患者糖尿病足溃疡的经济学评价。

Economic Evaluation of Sucrose Octasulfate Dressing for Treatment of Diabetic Foot Ulcers in Patients with Type 2 Diabetes.

机构信息

School of Public Health, University of Alberta, Edmonton, Alberta, Canada.

Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.

出版信息

Can J Diabetes. 2022 Mar;46(2):126-133. doi: 10.1016/j.jcjd.2021.07.001. Epub 2021 Jul 9.

Abstract

OBJECTIVES

Patients with noninfected neuroischemic diabetic foot ulcers (DFUs) treated with sucrose octasulfate (SOS) dressing have been shown to have improved healing compared with patients wearing a similar type of dressing without SOS. In this study, we aimed to estimate the cost-effectiveness of SOS dressing compared with conventional dressings from a Canadian public payer's perspective.

METHODS

We built a Markov model in a hypothetical cohort of 1,000 inpatients with type 2 diabetes with DFUs. The time horizon was 5 years, and the cycle length was 3 months. We incorporated effectiveness data from the Explorer trial and cohort studies, cost data (2020 Canadian dollars) from published Canadian studies and administrative databases, and utility parameters from the Alberta's Caring for Diabetes cohort. We used probabilistic analysis to calculate the incremental cost-effectiveness ratio of SOS dressing compared with conventional dressings.

RESULTS

In the comparison with conventional dressings, use of SOS dressing resulted in an expected increase of 0.16 quality-adjusted life-year (QALY) and an expected $5,878 decrease in health-care costs over 5 years. Adding SOS dressing resulted in a cost savings of $37,061 for every QALY gained. The probability that adding SOS dressing is cost-saving and cost-effective compared with conventional dressings was 89% and 86%, respectively, at a $50,000/QALY willingness-to-pay threshold.

CONCLUSIONS

SOS dressing accelerates ulcer healing and helps reduce the spending induced by persistent ulcer management and amputation. Therefore, SOS dressing is likely to be cost-effective and cost-saving, which is consistent with previous health technology assessments in other health-care systems.

摘要

目的

与使用不含蔗糖八硫酸酯(SOS)敷料的患者相比,接受蔗糖八硫酸酯(SOS)敷料治疗的非感染性神经缺血性糖尿病足溃疡(DFU)患者的愈合情况得到改善。本研究旨在从加拿大公共支付者的角度评估 SOS 敷料与传统敷料相比的成本效益。

方法

我们在一个有 1000 名 2 型糖尿病合并 DFU 住院患者的假设队列中建立了一个马尔可夫模型。时间范围为 5 年,周期长度为 3 个月。我们结合了 Explorer 试验和队列研究的有效性数据、来自已发表的加拿大研究和行政数据库的成本数据(2020 加元)以及艾伯塔省 Caring for Diabetes 队列的效用参数。我们使用概率分析来计算 SOS 敷料与传统敷料相比的增量成本效益比。

结果

与传统敷料相比,使用 SOS 敷料在 5 年内预计会增加 0.16 个质量调整生命年(QALY),并预计会降低 5878 加元的医疗保健费用。每获得一个 QALY,SOS 敷料的使用可节省 37061 加元。与传统敷料相比,添加 SOS 敷料在 50000 加元/QALY 的意愿支付阈值下,具有成本效益的概率为 89%,具有成本节约的概率为 86%。

结论

SOS 敷料可加速溃疡愈合,并有助于减少持续溃疡管理和截肢所导致的支出。因此,SOS 敷料可能具有成本效益,这与其他医疗保健系统的先前卫生技术评估结果一致。

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