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基于随机对照试验的加味归脾汤与黄连解毒汤治疗失眠症的成本效益分析

The Cost-Effectiveness Analysis of Gamiguibi-Tang versus Hwangryunhaedok-Tang for Patients with Insomnia Disorder Based on a Randomized Controlled Trial.

作者信息

Lee Ji-Eun, Jung In-Chul, Lee So-Young, Lim Jung-Hwa, Kim Bo-Kyung, Cho Eun

机构信息

College of Pharmacy, Sookmyung Women's University, Seoul 04310, Korea.

Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon 34520, Korea.

出版信息

Healthcare (Basel). 2022 Oct 28;10(11):2157. doi: 10.3390/healthcare10112157.

Abstract

(1) Insomnia is associated with poor quality of life and loss of productivity, and is a significant economic burden on society. Gamiguibi-tang (GGBT) is the most frequently prescribed herbal medicine for insomnia treatment. Hwangryunhaedok-tang (HHT) is used as an insured herbal medicine for insomnia in the Korean National Health Insurance (NHI) system. This study aims to evaluate the cost-effectiveness of GGBT versus HHT in patients with insomnia disorders based on clinical trial data; (2) Methods: The EuroQol five-dimension scale (EQ-5D) was used to estimate quality-adjusted life-years (QALY). Direct and non-direct medical costs and lost productivity costs were estimated. The cost-effectiveness of GGBT was compared with HHT treatments over six weeks from a societal perspective; (3) Results: A total of 81 patients who underwent GGBT (n = 56) and HHT (n = 25) treatment completed the clinical trial. The EQ-5D score improved significantly more in the GGBT than in the HHT group (0.02 vs. −0.03, p < 0.05). The QALYs for six weeks were slightly greater in GGBT (0.0997) than in the HHT group (0.0987); however, the total costs incurred were approximately 9% less in GGBT ($934) than in the HHT group ($1029). GGBT was found to be a more economically dominant treatment option compared to HHT for treating insomnia; (4) Conclusions: Among herbal medicines, GGBT may be a cost-effective option for treating insomnia from a societal perspective in Korea.

摘要

(1)失眠与生活质量差和生产力下降相关,是社会的一项重大经济负担。加味归脾汤(GGBT)是治疗失眠最常用的草药。黄连解毒汤(HHT)在韩国国民健康保险(NHI)系统中用作失眠的医保草药。本研究旨在基于临床试验数据评估加味归脾汤与黄连解毒汤治疗失眠症患者的成本效益;(2)方法:采用欧洲五维健康量表(EQ - 5D)来估计质量调整生命年(QALY)。估计直接和非直接医疗成本以及生产力损失成本。从社会角度比较加味归脾汤与黄连解毒汤六周治疗的成本效益;(3)结果:共有81例接受加味归脾汤(n = 56)和黄连解毒汤(n = 25)治疗的患者完成了临床试验。加味归脾汤组的EQ - 5D评分改善明显大于黄连解毒汤组(0.02对 - 0.03,p < 0.05)。加味归脾汤六周的QALY略高于黄连解毒汤组(0.0997对0.0987);然而,加味归脾汤产生的总成本(934美元)比黄连解毒汤组(1029美元)低约9%。发现加味归脾汤在治疗失眠方面比黄连解毒汤是更具经济优势的治疗选择;(4)结论:在草药中,从韩国社会角度来看,加味归脾汤可能是治疗失眠的一种具有成本效益的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8eb5/9690131/23f7607f9936/healthcare-10-02157-g001.jpg

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