摘要
Abstract
Objective To evaluate the cost-effectiveness and cost-utility of Qizhengxiaotong Plaster for the treatment of pain caused by osteoarthritis (OA). Methods Using multistage sampling,we enrolled 750 OA patients from 22 hospitals in 15 cities (Beijing,Lhasa,Taiyuan,Ji′ nan,Wuhan,Luoyang,Xining,Zhengzhou,Hangzhou,Tangshan, Wenzhou,Tianjin,Luohe,Chongqing and Ruian)of China between January 2013 and March 2014. Of them,360 cases received Qizhengxiaotong Plaster treatment were assigned to the experimental group,and other 390 cases received Yunnanbaiyao Plaster treatment were assigned to the control group. The therapeutic effectiveness was evaluated by the duration of pain and visual analog score (VAS)measured at the end of the treatment. The utility of the treatment was evaluated by quality-adjusted life years (QALYs). Propensity score matching (PSM)was used to reduce the bias due to confounding variables during the estimation of the treatment. Cost-effectiveness analysis and cost-utility analysis were conducted in the matched samples. Results According to the matching requirements,a total of 730 patients were finally enrolled. The baseline characteristics between two groups were comparable after matching. Compared with the control group,the duration of pain was reduced by 5. 3 d (49. 1 d vs. 43. 5 d,P < 0. 05),the VAS score was decreased by 0. 85 (3. 50 vs. 2. 65,P < 0. 01),the QALYs gained were 0. 01 higher (0. 18 QALYs vs. 0. 19 QALYs,P < 0. 01),and the total cost was increased by 957 yuan (1968 yuan vs. 1011 yuan,P <0. 01)in the experimental group. The direct medical cost and indirect cost were all higher in the experimental group compared with the control group (P < 0. 05). Cost-effectiveness analysis indicated that the experimental group involved the additional cost of 182 yuan in case of reducing 1-day OA-induced pain,and 1131 yuan in case of a reduction in VAS by 1 point;cost-utility analysis demonstrated that,the experimental group involved the additional cost of 86400 yuan in case of gaining 1 quality -adjusted life year. Conclusion Based on the cost-effectiveness threshold in the field of health set by WHO (3 times of GDP per capita),Qizhengxiaotong Plaster is considered to be a cost-effective therapy in the treatment of OA-induced pain instead of Yunnanbaiyao Plaster.关键词
骨关节炎/疼痛/经济学,药学Key words
Osteoarthritis/Pain/Economics,pharmaceutical分类
医药卫生
