【摘要】 目的对仙灵骨葆胶囊治疗绝经后妇女髋骨骨质疏松进行成本-效果分析,为骨质疏松的治疗及支付提供循证决策依据。方法从支付方角度出发,基于仙灵骨葆的随机对照临床试验,构建决策树模型,模拟骨质疏松骨折的进展并预测仙灵骨葆治疗10年的疗效。仙灵骨葆及安慰剂治疗1年后,股骨颈骨密度(BMD)值的变化用于预测髋骨骨折发生率,进而预测两组患者病死率。结果仙灵骨葆组治疗绝经后骨质疏松症的总成本为$6911.77,而安慰剂治疗组的总成本为$5789.69;仙灵骨葆组患者10年人均质量调整生命年(QALY)值为5.302,安慰剂治疗组患者10年人均QALY值为5.286;与安慰剂治疗组相比,仙灵骨葆治疗绝经后骨质疏松症的增量成本效果比(ICER)为$70 396.91/QALY,低于中国各省份3倍国内生产总值(GDP)阈值。结论与安慰剂治疗相比,仙灵骨葆治疗绝经后妇女骨质疏松症更具成本-效果。更多还原

【Abstract】 Objective To investigate the cost-effectiveness of Xian Ling Gu Bao for the treatment of postmenopausal osteoporosis in China and to provide evidence supporting medical decision making process.Methods A decision-tree model based on the RCT was developed to simulate the progression of postmenopausal osteoporosis and to predict the outcomes of XLGB treatment over 10 years.After one-year treatment of XLGB vs placebo,changes in bone mineral density(BMD) in femoral neck were utilized to predict the risk of hip fracture and the risk of hip-fracture related mortality was also included in the model. Results The total cost for Xian Ling Gu Bao group was $6,911.77 while the total cost for placebo group was $5,789.69.The QALY of Xian Lin Gu Bao group was 5.302 while that of placebo group was 5.286.The ICER value was $70,396.91 /QALY,which is below the WHO recommended 3 times GDP ICER threshold in all Chines provinces.Conclusion Compared with placebo,Xian Ling Gu Bao is a costeffective alternative for the treatment of postmenopausal osteoporosis.更多还原