五种保肝药物治疗药物性肝损伤的成本-效果分析  

Cost-effectiveness analysis of five hepatoprotective drugs in the treatment of drug-induced liver injury

作　　者：蒋范黎 刘永军[1] 邱玉 冷楠楠 JIANG Fanli;LIU Yongjun;QIU Yu;LENG Nannan(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]中国药科大学国际医药商学院,江苏南京210000

出　　处：《世界临床药物》2023年第8期832-840,共9页World Clinical Drug

摘　　要：目的对临床常用的5种保肝药物注射剂进行药物经济学分析。方法从中国卫生体系角度出发,根据药物性肝损伤疾病特点,构建Markov模型,对复方甘草酸苷、多烯磷脂酰胆碱、异甘草酸镁、甘草酸二铵及还原型谷胱甘肽5种保肝药物进行成本-效果分析,并进行敏感性分析以验证结果稳健性。结果对于药物性肝损伤患者,甘草酸二铵、多烯磷酯酰胆碱及还原型谷胱甘肽相比于复方甘草酸苷是绝对劣势治疗方案,而异甘草酸镁组相比于复方甘草酸苷,效果更优,成本更高,其增量成本-效果比=3500.57/质量调整生命年,远低于阈值(3倍我国人均GDP),是最优治疗方案。敏感性分析结果与基础分析结果一致,所有参数变动未改变模型结果。结论异甘草酸镁是最具经济性的治疗方案,建议临床保肝治疗选用异甘草酸镁,以提高整体社会效益,促进医疗资源合理配置。Objective To conduct pharmacoeconomic analysis of 5 liver protective drug injections commonly used in clinic.Methods From the perspective of China's health system,Markov model was constructed according to the characteristics of drug-induced liver injury disease.The cost-effectiveness of 5 hepatoprotective drugs,including compound glycyrrhizin glucoside,polyene phosphatidyl choline,magnesium isoglycyrrhizinate,diammonium glycyrrhizinate and reduced glutathione were analyzed,and sensitivity analysis was performed to verify the robustness of the results.Results For patients with drug-induced liver injury,diammonium glycyrrhizinate,polyene phosphatidyl choline and reduced glutathione are the absolute inferior treatment regimen compared with compound glycyrrhizin,while magnesium isoglycyrrhizinate is more effective and higher cost than compound glycyrrhizin,and its incremental cost effect ratio incremental cost effectiveness ratio=3500.57/quality adjusted life year is far less than the threshold value(3 times China's GDP per capita),which is the optimal treatment.The sensitivity analysis results were consistent with the basic analysis results,and all parameters changes did not change the model results.Conclusion Magnesium isoglycyrrhizinate is the most economical treatment plan,it is suggested to use magnesium isoglycyrrhizinate in clinical hepatoprotective treatment,in order to improve the overall social benefit and promote the rational allocation of medical resources.

关 键 词：保肝药物 药物性肝损伤 MARKOV模型 成本-效果分析 

分 类 号：R747.2[医药卫生—神经病学与精神病学]