脾氨肽口服溶液联合氯雷他定和等渗洗鼻盐水治疗儿童过敏性鼻炎合并腺样体肥大的成本-效果  

Cost-effectiveness of Spleen Aminopeptide Oral Solution combined with Loratadine and Isotonic Nasal wash Saline in the Treatment of Allergic Rhinitis combined with Adenoidal Hypertrophy in Children

作　　者：商雨朦 张方 李明如 扶春阳 曾帅 许政敏[4] SHANG Yu-Meng;ZHANG Fang;LI Ming-Ru;FU Chun-Yang;ZENG Shuai;XU Zheng-Min(Hainan Zhongwei Health Economic Development Research Institute,Haikou 570106,China;Health Care Security and Pharmacoeconomic Evaluation Branch of China Medical Education Association,Beijing 10007l,China;School of Business Administration,Shenyang Pharmaceutical University,Shenyang 110000,China;Otorhinolaryngology-Head and Neck Surgery.Pediatric Hospital of Fudan University,Children's National Medical Center,Shanghai 201100,China)

机构地区：[1]海南中卫健康经济发展研究院,海口570106 [2]中国医药教育协会医疗保障与药物经济学评价分会,北京100071 [3]沈阳药科大学工商管理学院,沈阳110000 [4]国家儿童医学中心复旦大学附属儿科医院耳鼻咽喉头颈外科,上海201100

出　　处：《中国药物经济学》2024年第12期5-10,共6页China Journal of Pharmaceutical Economics

摘　　要：目的基于全社会角度评估脾氨肽口服溶液联合氯雷他定和等渗洗鼻盐水治疗过敏性鼻炎(AR)合并腺样体肥大(AH)患儿的短期成本与效果,为临床合理用药和卫生资源合理配置提供参考。方法基于临床试验(ChiCTR2200056763)和文献研究数据构建马尔科夫模型,评估AR合并AH患儿使用脾氨肽口服溶液联合氯雷他定和等渗洗鼻盐水相较氯雷他定和等渗洗鼻盐水的短期成本和健康产出,其中成本包含直接医疗成本、直接非医疗成本和间接成本,使用质量调整生命年(QALYs)作为健康产出指标,最终计算两种治疗方案的增量成本-效果比(ICER)。采用单因素敏感性分析和概率敏感性分析验证基础分析结果的稳定性。结果含有脾氨肽口服溶液的治疗方案成本更高,效果更好,两种治疗方案的成本分别为3029.07元和2038.78元,效果值分别为0.8993 QALYs和0.8851 QALYs,ICER值为69609.87元/QALY,小于1倍人均国内生产总值(GDP),敏感性分析验证了基础分析结果的稳定性。结论从全社会角度出发,对于AR合并AH患儿,当意愿支付(WTP)值为1倍人均GDP时,脾氨肽口服溶液联合氯雷他定和等渗洗鼻盐水相较氯雷他定和等渗洗鼻盐水治疗具有经济学优势。Objective To assess the cost-effectiveness of whether loratadine and isotonic nasal wash saline is combined with spleen aminopeptide oral solution in afflicted child with Allergic Rhinitis(AR)combined with Adenoidal Hypertrophy(AH)from the perspective of the societal perspective.With a view to guide the rational allocation of health resources in clinical practice.Methods Construction of a Markov model based on data from clinical trials(ChiCTR2200056763)and literature studies to assess the short-term costs and health outputs of loratadine and isotonic nasal wash saline in combination with/without spleen aminopeptide oral solution in afflicted child with AR combined with AH.Costs include direct medical costs,direct non-medical costs,and indirect costs.Using Quality Adjusted Life Years(QALY)as a health output.Final calculation of the Incremental Cost Effectiveness Ratio(ICER)of the two treatment options.The basic analysis results was verified by one-way sensitivity analysis and probabilistic sensitivity analysis.Results Spleen aminopeptide oral solution combined with loratadine and isotonic nasal wash saline has significant efficacy in children with AR combined with AH.Cost-effectiveness studies have shown that treatment regimens containing spleen aminopeptide oral solution cost more and are more effective.The costs of the two treatment programs were￥2038.78 and￥3029.07),and the efficacy were 0.8851 QALYs and 0.8993 QALYs.ICER were￥69609.87 per QALY,less than 1time of Chinese Gross Domestic Product(GDP)per capita.The result of sensitivity analysis verified that the basic analysis results was robust.Conclusion From a societal perspective,for afflicted child with AR combined with AH,loratadine and isotonic nasal wash saline in combination with spleen aminopeptide oral solution has an economic advantage over loratadine monotherapy when the Willing to Pay(WTP)value is 1 time of GDP per capita.

关 键 词：脾氨肽口服溶液 儿童 腺样体肥大 过敏性鼻炎 成本-效果分析 

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