School of Public Health, Jilin University, Changchun 130012, China.
Int J Environ Res Public Health. 2022 Aug 13;19(16):9986. doi: 10.3390/ijerph19169986.
Objective The aim of this study was to investigate the cost-effectiveness of Helicobacter pylori () screening and eradication treatment in an asymptomatic population in China and to explore the most cost-effective screening protocol for . Method We used TreeAge 2019 to construct Markov models to assess the direct healthcare costs and quality-adjusted life years (QALYs) and the cost per year of life saved (YoLS) of three therapies, i.e., annual, triennial and five-yearly screening. Excess probabilities were derived from published high quality studies and Meta-analyses, and costs and utilities were derived from the Chinese Yearbook of Health Care Statistics and published studies. Incremental cost-effectiveness ratios (ICERs) were used to describe the results. The willingness-to-pay threshold was set at China's Gross National Product per capita. Result In the asymptomatic population, the ICER per QALYs gained was US$1238.47 and US$1163.71 for every three and five years of screening compared to the annual screening group; the ICER per YoLS gained was US$3067.91 and US$1602.78, respectively. Conclusion Screening for in asymptomatic populations in China and eradicating treatment for those who test positive is cost-effective. Increasing screening participation in asymptomatic populations is more effective than increasing the frequency of screening. From a national payer perspective, it is cost-effective to screen the general asymptomatic population in China for and to eradicate those who test positive. Individuals need to choose a screening programme that they can afford according to their financial situation.
本研究旨在探讨在中国无症状人群中进行幽门螺杆菌()筛查和根除治疗的成本效益,并探索最具成本效益的筛查方案。
我们使用 TreeAge 2019 构建了马尔可夫模型,以评估三种治疗方法(即每年、每三年和每五年一次的筛查)的直接医疗成本、质量调整生命年(QALYs)和每挽救一年生命的成本(YoLS)。超额概率来自已发表的高质量研究和荟萃分析,成本和效用来自中国卫生统计年鉴和已发表的研究。增量成本效益比(ICER)用于描述结果。意愿支付阈值设定为中国的人均国民生产总值。
在无症状人群中,与每年筛查组相比,每三年和每五年筛查一次的 QALY 增量成本效益比分别为 1238.47 美元和 1163.71 美元,YoLS 增量成本效益比分别为 3067.91 美元和 1602.78 美元。
在中国无症状人群中进行筛查和对阳性者进行根除治疗是具有成本效益的。增加无症状人群的筛查参与度比增加筛查频率更有效。从国家支付者的角度来看,在中国对一般无症状人群进行筛查并根除阳性者是具有成本效益的。个人需要根据自己的财务状况选择自己能够负担得起的筛查方案。