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中国治疗绝经后骨质疏松症的中成药成本效益分析

Cost-effectiveness analysis of Chinese patent medicines for the treatment of postmenopausal osteoporosis in China.

作者信息

Wang Cong, Lin Xihan, Liu Jinyu, Zhang Yu, You Ruxu

机构信息

Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Front Public Health. 2025 Sep 5;13:1596676. doi: 10.3389/fpubh.2025.1596676. eCollection 2025.

Abstract

INTRODUCTION

Evidence indicates that Chinese patent medicines can significantly increase bone mass in patients with osteoporosis and alleviate symptoms associated with low bone density. Although the therapeutic effects of these two drugs have been compared both directly and indirectly, no economic-related studies currently exist. Therefore, this study aims to assess the cost-effectiveness of Xianling Gubao Capsules compared to Jintiange Capsules and non-treatment for postmenopausal osteoporosis from the perspective of Chinese healthcare providers.

METHODS

A Markov microsimulation model was employed to estimate the cost-effectiveness of the Xianling Gubao capsule and the Jintiange capsule in a hypothetical cohort of postmenopausal osteoporotic women aged 55 to 74 years with no prior history of fractures, over a treatment period of 6 months. Model parameters, including transition probabilities and costs, were derived from Chinese sources. Efficacy data for the treatments were obtained from two network meta-analyses. Outcomes were expressed as incremental costs per quality-adjusted life-year (QALY) gained. Sensitivity analyses were performed to ensure the robustness of the findings, with a cost-effectiveness threshold established at three times the Gross Domestic Product (GDP) per capita in China ($38,223) per QALY.

RESULT

Compared to the control group that did not receive drug treatment, the preventive therapy using Chinese patent medicine significantly increased bone mineral density and reduced the probability of fractures across all age groups in the intervention group. The incremental cost-effectiveness ratios (ICERs) for the Jintiange capsule compared to the Xianling Gubao capsule ranged from $11,955 per QALY at age 55 to $9,711 per QALY at age 74, indicating that the cost-effectiveness of the Jintiange capsule improved consistently with age. Sensitivity analyses confirmed the robustness of the results across all parameter variations, with the annual cost of the Jintiange capsule identified as the most sensitive factor.

CONCLUSION

From the perspective of Chinese healthcare providers, preventive therapy using Chinese patent medicine, when compared to a control group that did not receive drug treatment, resulted in increased bone mineral density and a reduced probability of fractures across all age levels in the intervention group. Additionally, the Jintiange capsule appears to be a cost-effective treatment option for postmenopausal women with osteoporosis.

摘要

引言

有证据表明,中成药可显著增加骨质疏松症患者的骨量,并缓解与低骨密度相关的症状。尽管已对这两种药物的治疗效果进行了直接和间接比较,但目前尚无经济相关研究。因此,本研究旨在从中国医疗服务提供者的角度评估仙灵骨葆胶囊与金天格胶囊及不治疗相比,用于绝经后骨质疏松症的成本效益。

方法

采用马尔可夫微观模拟模型,在一个假设队列中,对年龄在55至74岁、无骨折病史的绝经后骨质疏松女性进行为期6个月的治疗,评估仙灵骨葆胶囊和金天格胶囊的成本效益。模型参数,包括转移概率和成本,均来自中国资料。治疗的疗效数据来自两项网络荟萃分析。结果以每获得一个质量调整生命年(QALY)的增量成本表示。进行敏感性分析以确保研究结果的稳健性,成本效益阈值设定为中国人均国内生产总值(GDP)的三倍(每QALY为38,223美元)。

结果

与未接受药物治疗的对照组相比,使用中成药的预防性治疗显著提高了干预组所有年龄组的骨密度,并降低了骨折概率。金天格胶囊与仙灵骨葆胶囊相比,增量成本效益比(ICER)从55岁时的每QALY 11,955美元到74岁时的每QALY 9,711美元不等,表明金天格胶囊的成本效益随年龄增长而持续改善。敏感性分析证实了所有参数变化下结果的稳健性,金天格胶囊的年度成本被确定为最敏感因素。

结论

从中国医疗服务提供者的角度来看,与未接受药物治疗的对照组相比,使用中成药的预防性治疗使干预组所有年龄层的骨密度增加,骨折概率降低。此外,金天格胶囊似乎是绝经后骨质疏松症女性具有成本效益的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a26/12446330/afc83ccdbb5d/fpubh-13-1596676-g001.jpg

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