布洛芬注射液用于儿童扁桃体切除术术后镇痛经济学评价  

Economic Evaluation of Ibuprofen Injection for Postoperative Analgesia in Pediatric Tonsillectomy

作　　者：陈沁敏 邓毅 周一康 田燕 胡明[1] CHEN Qinmin;DENG Yi;ZHOU Yikang;TIAN Yan;HU Ming(West China School of Pharmacy,Sichuan University,Chengdu,Sichuan,China 610041;The Affiliated Women′s and Children′s Hospital,School of Medicine,UESTC·Chengdu Women′s and Children′s Central Hospital,Chengdu,Sichuan,China 611731;Department of Pharmacy,West China Hospital,Sichuan University,Chengdu,Sichuan,China 610041)

机构地区：[1]四川大学华西药学院,四川成都610041 [2]电子科技大学医学院附属妇女儿童医院·四川省成都市妇女儿童中心医院,四川成都611731 [3]四川大学华西医院药剂科,四川成都610041

出　　处：《中国药业》2022年第15期108-113,共6页China Pharmaceuticals

基　　金：国家自然科学基金[71473170]。

摘　　要：目的评价布洛芬注射液用于儿童扁桃体切除术术后镇痛的经济性。方法从全社会角度出发,基于一项多中心、随机、双盲、安慰剂对照的临床研究,采用TreeAge Pro 2011软件构建短期决策树模型,应用条件价值评估法收集不同效果指标下患者的意愿支付(WTP)值,分析试验组[布洛芬注射液10 mg/kg(不超过600 mg)联合常规麻醉镇痛]和对照组(0.9%氯化钠注射液10 mg/kg联合常规麻醉镇痛)治疗方案的成本-效果优势,并采用单因素敏感性分析和概率敏感性分析评估模型结果的稳定性。结果以术后视觉模拟评分(VAS)法评分为效果指标时,增量成本-效果比(ICER)为5.68元/(分•小时),低于该指标WTP阈值49.81元/(分•小时),对ICER影响较大的前5位因素分别为对照组VAS评分、试验组VAS评分、试验组镇痛成本、对照组药品不良反应(ADR)成本、试验组ADR成本;以术后不加用芬太尼为有效率指标时,ICER为515.39元,低于该指标WTP阈值781.94元,布洛芬注射液具有成本-效果优势的概率为99.50%,对ICER影响较大的前5位因素分别为试验组镇痛成本、试验组术后不加用芬太尼的概率、试验组ADR的预防费用、对照组ADR的预防费用、对照组镇痛成本;以术后不加用或加用1次芬太尼为有效率指标时,ICER为276.68元,低于该指标WTP阈值293.73元,布洛芬注射液具有成本-效果优势的概率为64.40%,对ICER影响较大的前5位因素分别为试验组不加用或加用1次芬太尼后有效的概率、对照组不加用或加用1次芬太尼后有效的概率、试验组镇痛成本、试验组ADR的预防费用、对照组ADR的预防费用。结论与安慰剂相比,布洛芬注射液用于儿童扁桃体切除术术后镇痛具有成本-效果优势。Objective To evaluate the economy of Ibuprofen Injection for postoperative analgesia in the pediatric tonsillectomy.Methods From the perspective of the whole society,based on a multicentric,randomized,double-blind clinical study with the placebo as control,a short-term decision tree model was constructed by the TreeAge Pro 2011 software.The willingness-to-pay(WTP)of patients under different effectiveness indicators were collected by the contingent valuation method.The cost-effectiveness advantages of the treatment schemes in the test group(10 mg/kg of Ibuprofen Injection,with no more than 600 mg,combined with conventional anesthesia for analgesia)and the control group(10 mg/kg of 0.9%Sodium Chloride Injection combined with conventional anesthesia for analgesia)were analyzed.The stability of the model was evaluated by the single-factor sensitivity analysis and the probabilistic sensitivity analysis.Results When the postoperative visual analogue scale(VAS)score was taken as the effectiveness indicator,the incremental cost-effectiveness ratio(ICER)was CNY 5.68/(point·h),which was lower than the WTP threshold of CNY 49.81/(point·h)under this indicator.The top five factors that had a great impact on the ICER were the VAS score in the control group,the VAS score in the test group,the analgesia cost in the test group,the cost of adverse drug reaction(ADR)in the control group and the cost of ADR in the test group,respectively.When no use of fentanyl after operation was taken as the effectiveness indicator,the ICER was CNY 515.39,which was lower than the WTP threshold of CNY 781.94 under this indicator.The probability of the cost-effectiveness advantage of Ibuprofen Injection was 99.50%.The top five factors that had a great impact on the ICER were the analgesia cost in the test group,the probability of no use of fentanyl after operation in the test group,the cost of preventing ADR in the test group,the cost of preventing ADR in the control group and the analgesia cost in the control group,respectively.When no use of fen

关 键 词：布洛芬注射液 扁桃体切除术 术后镇痛 决策树模型 条件价值评估法 成本-效果 药物经济学 

分 类 号：R956[医药卫生—药学] R971