Pharmacoeconomic Evaluation of α-Lipoic Acid Alone or Combined with Mecobalamin versus Mecobalamin in the Adjunctive Treatment of Diabetic Peripheral Neuropathy
- VernacularTitle:α-硫辛酸单用及其与甲钴胺联用对比甲钴胺辅助治疗糖尿病周围神经病变的药物经济学评价
- Author:
Hongmei WANG
1
;
Nan YANG
2
;
Qian XU
2
;
Lingxi KONG
1
;
Feng QIU
1
;
Xuefeng SHAN
1
Author Information
1. Dept. of Pharmacy，the First Affiliated Hospital of Chongqing Medical University，Chongqing 400016，China
2. West China School of Pharmacy，Sichuan University，Chengdu 610041，China
- Publication Type:Journal Article
- Keywords:
α-Lipoic acid injection;
Mecobalamin injection;
Diabetic peripheral neuropathy;
Meta-analysis;
Cost-effectiveness analysis
- From:
China Pharmacy
2019;30(5):689-693
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE： To evaluate the clinical efficacy and economics of α-lipoic acid injection alone or combined with Mecobalamin injection versus Mecobalamin injection in the adjunctive treatment of diabetic peripheral neuropathy （DPN）. METHODS： Retrieved from PubMed， Cochrane Library， Embase， CNKI， VIP， CBM and Wanfang database， using “mecobalamin” “α-lipoic acid” and“diabetic peripheral neuropathy”as Chinese retrieval words， “Thioctic acid” “α-lipoic acid” “Methylcobal” “Mecobalamin” “Diabetic peripheral neuropathy” as English retrieval words， relevant randomized controlled trials （RCTs） were collected during the date of database establishment to Aug. 30th， 2018. Meta-analysis was conducted for total response rate. From the perspective of health care providers， cost-effectiveness analysis was used for economic evaluation and sensitivity analysis was conducted by a 15％ fluctuation of cost and total response rate. RESULTS： Totally 13 RCTs were included， involving 1 131 patients. The results of Meta-analysis showed that the total response rate of two-drug combination therapy in the treatment of DPN was higher than that of mecobalamin alone [RR＝1.41， 95％CI（1.28， 1.55）， P＜0.000 01]； that of α-lipoic acid injection alone in the treatment of DPN was higher than that of mecobalamin injection alone [RR＝1.35， 95％CI（1.25，1.47）， P＜0.000 01]， with statistical significance. Results of cost-effectiveness analysis showed that the cost-effectiveness ratio （CER） of Mecobalamin injection was 211.38 yuan， and CER of two-drug combination and α-lipoic acid injection alone were 1 484.42 and 1 383.49 yuan， respectively. The incremental cost-effectiveness ratio （ICER） were 4 589.52 and 4 638.82 yuan， which were all lower than per capita GDP in 2017. Sensitivity analysis showed that the cost-effectiveness analysis results kept stable. CONCLUSIONS： Compared with Mecobalamin injection， α-lipoic acid injection combined with Mecobalamin injection in the adjunctive treatment of DPN show high total response rate and economics.
