3种第二代抗组胺药治疗儿童过敏性鼻炎的成本-效果  

Cost-Effectiveness of Three Second-generation Antihistamines in the Treatment of Allergic Rhinitis in Children

作　　者：莫晓媚[1,2] 李国菊 赵荣达 赵娜 徐鲁杰[2] 刘青 陈文静 闫美兴 MO Xiao-Mei;LI Guo-Ju;ZHAO Rong-Da;ZHAO Na;XU Lu-Jie;LIU Qing;CHEN Wen-Jing;YAN Mei-Xing(College of Medicine,Ocean University of China,Qingdao 266003,China;Department of Pharmacy,Women and Children's Hospital Affiliated to Qingdao University,Qingdao 266034,China;Comprehensive birth Defects Control Center,Women and Children's Hospital Affiliated to Qingdao University,Qingdao 266034,China;Qingdao maternal and child health and family planning service center,Qingdao 266034,China)

机构地区：[1]中国海洋大学医药学院,山东青岛266003 [2]青岛大学附属妇女儿童医院药学部,山东青岛266034 [3]青岛大学附属妇女儿童医院出生缺陷综合防治中心,山东青岛266034 [4]青岛市妇幼保健计划生育服务中心,山东青岛266034

出　　处：《中国药物经济学》2023年第11期21-26,31,共7页China Journal of Pharmaceutical Economics

基　　金：中国药学会全国医药信息网2022年科普研究重点项目(CMEI2022KPYJ001106);青岛市市级临床重点专科建设项目(2022-2024-77);北京医药卫生经济研究会资助项目(2020-9-9)。

摘　　要：目的运用药物经济学评价方法,对氯雷他定、西替利嗪、左西替利嗪3种第二代抗组胺药物治疗儿童过敏性鼻炎进行成本-效果分析,为临床治疗儿童过敏性鼻炎用药提供参考和建议。方法通过单组率Meta分析获得效果指标,于山东省药品招标采购平台,结合儿童各年龄段的服用剂量和疗程获得药品成本,对3种第二代抗组胺药物治疗儿童过敏性鼻炎进行成本-效果分析,并进行单因素敏感性分析、概率敏感性分析及基于药品成本变化的情境假设分析。结果对于治疗2~6岁儿童过敏性鼻炎,氯雷他定为绝对劣势方案被排除,西替利嗪相比于左西替利嗪的增量成本-效果比(ICER)为19.34元;对于治疗6~11岁儿童过敏性鼻炎,氯雷他定为绝对劣势方案被排除,西替利嗪相比于左西替利嗪的ICER为38.69元;对于治疗≥12岁儿童过敏性鼻炎,左西替利嗪、氯雷他定成本较高为绝对劣势方案被排除,西替利嗪为优势方案。敏感性分析与基础分析结果基本一致。结论第二代抗组胺药物治疗各年龄段儿童过敏性鼻炎,氯雷他定为绝对劣势方案;临床治疗2~11岁儿童过敏性鼻炎时,可以根据患儿的意愿支付(WTP)阈值选择最优方案,若WTP低于ICER,则优先使用左西替利嗪,若WTP高于ICER,则优先使用西替利嗪;临床治疗≥12岁儿童过敏性鼻炎时,西替利嗪为绝对优势方案。Objective To analyze the cost-effectiveness of loratadine,cetirizine and levocetirizine second-generation antihistamines in the treatment of allergic rhinitis in children by pharmacoeconomic evaluation,and to provide references and suggestions for the clinical treatment of allergic rhinitis in children.Methods The efficacy index was obtained by single group rate meta-analysis,and the cost-effectiveness analysis of 3 second-generation antihistamine drugs in the treatment of allergic rhinitis in children was conducted through the drug bidding and procurement platform of Shandong Province,combined with the cost of drugs obtained by the dosage and course of treatment of children at different ages.The single factor sensitivity analysis,probability sensitivity analysis and scenario hypothesis analysis based on drug cost change were also carried out.Results For the treatment of allergic rhinitis in children aged 2 to 6 years,loratat was excluded as an absolute disadvantage,the incremental cost-effectiveness ratio(ICER)of cetirizine compared with levocetirizine was 19.34 yuan.For the treatment of allergic rhinitis in children aged 6 to 11 years,loratat was excluded as an absolute disadvantage scheme,and the ICER of cetirizine was 38.69 yuan compared with levocetirizine.For the treatment of allergic rhinitis in children≥12 years old,the higher cost of levocetirizine and loratadine was excluded as the absolute disadvantage,and cetirizine was the advantage.The results of sensitivity analysis were basically consistent with those of basic analysis.Conclusion The second-generation antihistamine is an absolute disadvantage in the treatment of allergic rhinitis in children of all ages.In the clinical treatment of allergic rhinitis in children aged 2 to 11 years,the optimal plan can be selected according to the patient's willingness to pay(WTP)threshold.If WTP is lower than ICER,levocetirizine is preferred;if WTP is higher than ICER,cetirizine is preferred.Cetirizine is an absolute advantage in the clinical treatment of allergi

关 键 词：第二代抗组胺药 儿童过敏性鼻炎 成本-效果分析 增量成本-效果比 

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