结构脂肪乳三腔袋药物对比长链脂肪乳三腔袋药物治疗术后营养不良患者的成本-效果OA

Objective Using health economic modeling methods,this study aimed to explore the cost-effectiveness of structured lipid emulsion triple-chamber bag drug(SLE,StructoKabiven®)compared with long-chain lipid emulsion triple-chamber bag drug(LCLE,Kabiven®)in postoperative patients receiving parenteral nutrition in China.The study aimed to provide pharmacoeconomic evidence for relevant clinical and health insurance decisions.Methods From the perspective of the Chinese healthcare system,a decision tree model was used to simulate the use of the two evaluated drugs StructoKabiven® and Kabiven® in malnourished patients who were not suitable for enteral nutrition after surgery.The simulation period was the hospitalization period of the surgery,with the outcome measure the survival rate and the cost items being direct medical costs.The relevant parameters were obtained from published literature,expert consultation,and Phase Ⅲ clinical trials of the LCTLE drug.The robustness of the results was tested using univariate and probabilistic sensitivity analyses and scenario analysis.Results After simulating 1,000 patient cohorts using the decision tree model,the survival rate in the SLE group was 97.9%,with an average direct medical cost of 48 415.3 yuan.In the LCLE group,the survival rate was 96.9%,with an average direct medical cost of 50,501.9 yuan.Therefore,the SLE group had an absolute advantage.Univariate sensitivity analysis showed that the results remained consistent when the parameters were varied within the 95%confidence intervals as documented in the literature.Meanwhile,other parameters underwent adjustments within a range of±20%.Probabilistic sensitivity analysis showed that the probability of cost-effectiveness for the SLE group was 100%,and the results fell within the fourth quadrant.Scenario analysis using the commonly used partial parenteral nutrition administration method in clinical practice also showed an absolute advantage for SLE.Conclusion In the long term,under the existing evidence,SLE is more effective and less costly per patient compared with the commonly used LCLE triple-chamber bag nutrition covered by the current health insurance in China.The results are robust.