李科标;田杨;韩晟;林丽开;李薇;
LI Ke-biao;TIAN Yang;HAN Sheng;LIN Li-kai;LI Wei;Hospital Management Institute of Wuhan University;International Research Center for Medical Administration, Peking University;

• 1:武汉大学医院管理研究所
• 2:北京大学医药管理国际研究中心

摘要(Abstract)：

该研究旨在评价气滞胃痛颗粒治疗功能性消化不良的有效性、安全性与经济性。选取临床常用的治疗功能性消化不良方案：气滞胃痛颗粒+莫沙必利片vs单用莫沙必利片，基于已发表的临床研究进行Meta分析，评价治疗的有效性、安全性，并以Meta分析结果作为效果进行药物经济学评价。采用成本-效果手段对增量成本-效果比(ICER)进行分析，并通过旋风图、蒙特卡洛模拟进行敏感性分析。通过调研功能性消化不良患者，确定该病的意愿支付阈值，并与ICER对比，从对气滞胃痛颗粒的经济性进行评价。基础分析结果显示，气滞胃痛颗粒+莫沙必利片治疗功能性消化不良有效率为95.49%,高于单用莫沙必利片(73.30%)(OR=8.52,95%CI[4.36,16.64]),具有显著性差异(P<0.000 1)。安全性方面，2组无显著性差异。气滞胃痛颗粒+莫沙必利片价格相较于单用莫沙必利片更高，ICER为640.29元，但低于患者意愿支付阈值1 506.67元，敏感性分析显示结果较为稳健。综上，气滞胃痛颗粒+莫沙必利片治疗功能性消化不良安全且更加有效、经济，临床值得推广。
This study aims to investigate the efficacy, safety, and cost-effecctiveness of Qizhi Weitong Granules in the treatment of functional dyspepsia. Specifically, two commonly used clinical protocols for the treatment of functional dyspepsia were selected: Qizhi Weitong Granules+Mosapride vs Mosapride alone(control). Meta-analysis of previous clinical studies was performed to examine the efficacy and safety, and pharmacoeconomic evaluation was carried out according to the results of the Meta-analysis. The cost-effectiveness analysis was carried out to elucidated the incremental cost-effectiveness ratio(ICER), and the sensitivity was analyzed with tornado dia-gram and Monte Carlo simulation. The willingness-to-pay threshold of patients for functional dyspepsia was investigated and compared with the ICER to evaluate whether Qizhi Weitong Granules was cost-effective. The result showed that the effective rate of Qizhi Weitong Granules combined with Mosapride in the treatment of functional dyspepsia was 95.49%, which was higher than that of Mosapride alone(73.30%)(OR=8.52, 95%CI[4.36, 16.64])(P<0.000 1). The two groups showed no significant difference in safety. The price of Qizhi Weitong Granules+Mosapride was higher than that of Mosapride alone. The ICER was 640.29 CNY, 1 506.67 CNY lower than the willingness-to-pay threshold. The sensitivity analysis showed that the analysis results were relatively stable. Thus, Qizhi Weitong Granules+Mosapride is safe, effective, and economical in the treatment of functional dyspepsia, which should be further promoted in clinical settings.

关键词(KeyWords)： 气滞胃痛颗粒;功能性消化不良;成本-效果分析;Meta分析;决策树模型
Qizhi Weitong Granules;functional dyspepsia;cost-effectiveness analysis;Meta-analysis;decision tree model

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 李科标;田杨;韩晟;林丽开;李薇;
LI Ke-biao;TIAN Yang;HAN Sheng;LIN Li-kai;LI Wei;Hospital Management Institute of Wuhan University;International Research Center for Medical Administration, Peking University;

DOI: 10.19540/j.cnki.cjcmm.20220529.502

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