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柴银颗粒治疗流感的成本效益分析

[Cost-effectiveness analysis of Chaiyin Granules in treatment of influenza].

作者信息

Ding Li-Man, Yang Dao-Wen, Zhang Hong-Chun, Ma Xiao, Yan Zhen-Gang, Zhang Sheng-Tang, Ma Wu-Zhi, Li Wei-Ge, Wu Dong-Xing, Jiang Qing-Rong

机构信息

Zhejiang Chinese Medical University Hangzhou 310053,China.

China-Japan Friendship Hospital Beijing 100029,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2023 Aug;48(16):4529-4535. doi: 10.19540/j.cnki.cjcmm.20230323.501.

Abstract

This study aimed to evaluate the cost-effectiveness of Chaiyin Granules compared with Oseltamivir Phosphate Capsules in the treatment of influenza(exogenous wind-heat syndrome). Based on a randomized, double-blind, positive drug parallel control clinical trial, this study evaluated the pharmacoeconomics of Chaiyin Granules with cost-effectiveness analysis method. A total of 116 patients with influenza from eight hospitals(grade Ⅱ level A above) in 6 cities were selected in this study, including 78 cases in the experimental group with Chaiyin Granules and Oseltamivir Phosphate Capsules placebo, and 38 cases in the control group with Oseltamivir Phosphate Capsules and Chaiyin Granules placebo. The total cost of this study included direct medical cost, direct non-medical cost, and indirect cost. The remission time of clinical symptoms, cure time/cure rate, antipyretic onset time/complete antipyretic time, viral nucleic acid negative rate, and traditional Chinese medicine(TCM) syndrome curative effect were selected as the effect indicators for cost-effectiveness analysis. Four-quadrant diagram was used to estimate the incremental cost-effectiveness ratio. The results showed that Chaiyin Granules were not inferior to Oseltamivir Phosphate Capsules in the remission time of clinical symptoms of influenza(3.1 d vs 2.9 d, P=0.360, non-inferiority margin was 0.5 d). Compared with Oseltamivir Phosphate Capsules, Chaiyin Granules would delay the remission time of clinic symptoms of influenza for 1 d, but could save 213.9 yuan. 1 d delay in cure time could save 149.3 yuan; 1% reduction in the cure rate could save 8.2 yuan; 1 d delay in antipyretic onset time could save 295.4 yuan; 1 d delay in complete antipyretic time could save 114.3 yuan; 1% reduction in the 5-day cure rate of TCM syndrome could save 19.2 yuan. Different from other indicators, there was no statistically significant difference between two groups in the effect of negative conversion rate of viral nucleic acid, but the cost was lower and the effect was superior, and the pharmacoeconomics was not different from that of Oseltamivir Phosphate Capsules in the field of influenza treatment.

摘要

本研究旨在评价柴银颗粒与磷酸奥司他韦胶囊治疗流感(外感风热证)的成本效果。基于一项随机、双盲、阳性药物平行对照临床试验,本研究采用成本效果分析方法对柴银颗粒进行药物经济学评价。本研究选取了6个城市8家医院(二级甲等及以上)的116例流感患者,其中试验组78例,给予柴银颗粒和磷酸奥司他韦胶囊安慰剂;对照组38例,给予磷酸奥司他韦胶囊和柴银颗粒安慰剂。本研究的总成本包括直接医疗成本、直接非医疗成本和间接成本。选取临床症状缓解时间、治愈时间/治愈率、退热起效时间/完全退热时间、病毒核酸阴转率、中医证候疗效作为成本效果分析的效果指标。采用四象限图估算增量成本效果比。结果显示,柴银颗粒在流感临床症状缓解时间上不劣于磷酸奥司他韦胶囊(3.1天对2.9天,P = 0.360,非劣效界值为0.5天)。与磷酸奥司他韦胶囊相比,柴银颗粒会使流感临床症状缓解时间延迟1天,但可节省213.9元。治愈时间延迟1天可节省149.3元;治愈率降低1%可节省8.2元;退热起效时间延迟1天可节省295.4元;完全退热时间延迟1天可节省114.3元;中医证候5天治愈率降低1%可节省19.2元。与其他指标不同,两组在病毒核酸阴转率效果上无统计学差异,但成本更低且效果更优,在流感治疗领域的药物经济学与磷酸奥司他韦胶囊相当。

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