Economic evaluation of plasma exchange combined with dual plasma adsorption therapy for early, mid and late stage liver failure
10.3760/cma.j.cn501113-20190122-00025
- VernacularTitle:血浆置换联合双重血浆吸附治疗早、中、晚期肝衰竭的经济学评价
- Author:
Lingxi KONG
1
;
Feng QIU
;
Hongmei WANG
;
Xuefeng SHAN
;
Peng HU
;
Shan ZHONG
;
Na WANG
Author Information
1. 重庆医科大学附属第一医院药学部 400042
- Keywords:
Liver failure;
Liver, artificial;
Plasma exchange;
Economics
- From:
Chinese Journal of Hepatology
2020;28(5):434-440
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the economic characteristics of the four artificial liver models [plasma exchange, half-dose plasma exchange combined with double plasma adsorption (DPMAS), pre-equal amount of plasma exchange followed by DPMAS, and pre-DPMAS followed by equal amount of plasma exchange] in the treatment of liver failure.Methods:A decision tree model was established with the Treeage pro 2011 software. The cost-effectiveness ratio and incremental cost-effectiveness value of four different treatment modalities were calculated and compared in patients with liver failure at early, mid and late stages, respectively. The sensitivity analysis of the model was performed using data from the preliminary research results of these groups.Results:The cost-effectiveness ratio and incremental cost-effectiveness value of patients treated with artificial liver therapy with half-dose plasma exchange combined with DPAMS plan in early stage liver failure were 89 547.79 and 34 665.34, which was lower than per capita GDP, so the increased cost had cost-effective advantages. In the middle and late stage of liver failure, the cost-effectiveness ratio and incremental cost-effectiveness value of pre-DPMAS followed by equal plasma exchange plan was 122 865.5 and 284 334.97, and 70 744.55 and 75 299.48, respectively, which was less than three times of per capita GDP. The increased cost was acceptable and had economic advantages. The sensitivity analysis results showed that the basic analysis results were reliable.Conclusion:Half-dose plasma exchange combined with DPAMS plan is the most cost-effective treatment for early liver failure, while pre-DPMAS followed by equal plasma exchange plan is the most economical treatment for mid and late stage liver failure.
