苯环喹溴铵对比糠酸莫米松治疗变应性鼻炎的药物经济学评价  

Pharmacoeconomic Evaluation of Phencyquine Ammonium Bromide versus Mometasone Furoate in the Treatment of Allergic Rhinitis

作　　者：陈观贵[1] 石秀娟 汪海洋 CHEN Guan-Gui;SHI Xiu-Juan;WANG Hai-Yang(Department of Otolaryngology,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510630,China;Shandong First Medical University,Jinan 250000,China;College of Pharmacy,Shandong First Medical University,Tai'an 271000,China)

机构地区：[1]广州医科大学附属第二医院耳鼻咽喉科,广州510630 [2]山东第一医科大学,济南250000 [3]山东第一医科大学药学院,山东泰安271000

出　　处：《中国药物经济学》2023年第6期15-21,共7页China Journal of Pharmaceutical Economics

摘　　要：目的 对比分析苯环喹溴铵治疗变应性鼻炎(AR)的疗效与经济性,为临床提供更加经济、合理的AR用药方案建议。方法 构建苯环喹溴铵和糠酸莫米松治疗AR的Markov模型对患者接受治疗后的生存状态进行模拟,根据AR的疾病特征,模型包括疾病发作和疾病控制两种健康状态。选用决策树模型进行成本-效果分析;采用质量调整生命年(QALYs)作为健康产出指标,以2021年1倍人均GDP的意愿支付(WTP)阈值判断不同方案的经济性。结果 苯环喹溴铵方案总成本低于糠酸莫米松方案,同时患者获得了更高的生命质量,苯环喹溴铵治疗方案相较糠酸莫米松治疗方案增量成本-效果比(ICER)值为-9 682.54元/QALY,小于既定的1倍人均GDP的WTP,苯环喹溴铵方案与糠酸莫米松方案相比为优势方案。敏感性分析显示,糠酸莫米松和苯环喹溴铵方案第4周患者的鼻部总症状视觉尺度量表(Multi-VAS)评分是对ICER影响的主要因素,在既定WTP下,苯环喹溴铵对比糠酸莫米松具有经济性的概率为100%,苯环喹溴铵作为优势方案结果具有一定稳定性。结论 对于AR,抗胆碱能药苯环喹溴铵对比鼻用糖皮质激素糠酸莫米松具有绝对的成本-效果优势。Objective To compare and analyze the efficacy and economy of phenylcycloquine ammonium bromide in the treatment of allergic rhinitis,and to provide more economical and reasonable drug regimen recommendations for allergic rhinitis.Methods A Markov model was constructed to simulate the survival state of patients with allergic rhinitis after treatment with phenylcycloquinoline bromide and mometasone furoate.According to the disease characteristics of AR,the model included two kinds of health states:disease attack and disease control.The decision tree model is selected for cost-effectiveness analysis;Quality adjusted life years(QALYs) are used as health output indicators,and the economy of different schemes is judged by the willing payment threshold of one time of per capita GDP in 2021.Results The total cost of the scheme was lower than that of the scheme of mometasone furoate.At the same time,the patients obtained higher quality of life.The ICER value of the scheme was-9 682.54yuan/QALY compared with that of the scheme of mometasone furoate,which was less than the established WTP of twice the per capita GDP.The sensitivity analysis showed that the Multi-VAS score of patients in the fourth week of the regimen of mometasone furoate and phenylcycloquinoline bromide was the main factor affecting ICER.Under the given WTP,the economic probability of phenylcycloquinoline bromide compared with mometasone furoate was 100%,and the results of phenylcycloquinoline bromide as the superior regimen were stable.Conclusion For allergic rhinitis,the anticholinergic drug phenylcycloquinium bromide has an absolute cost-effectiveness advantage over the nasal glucocorticoid mometasone furoate.

关 键 词：苯环喹溴铵 变应性鼻炎 糠酸莫米松 药物经济学 MARKOV模型 成本-效果 

分 类 号：R765.21[医药卫生—耳鼻咽喉科] R956[医药卫生—临床医学]