Pharmacoeconomic evaluation of Qili qiangxin capsule in the treatment of chronic heart failure
- VernacularTitle:芪苈强心胶囊治疗慢性心力衰竭的药物经济学评价
- Author:
Haijing GUAN
1
;
Zhigang ZHAO
1
Author Information
1. Dept. of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China
- Publication Type:Journal Article
- Keywords:
Qili qiangxin capsule;
chronic heart failure;
clinical efficacy;
safety;
meta-analysis;
pharmacoeconomic
- From:
China Pharmacy
2022;33(2):209-216
- CountryChina
- Language:Chinese
-
Abstract:
OBJECT IVE To evaluate the efficacy ,safety and cost-effectiveness of Qili qiangxin capsule in the treatment of chronic heart failure ,and provide reference for drug selection and evaluation in relevant institutions. METHODS Meta-analysis was performed to investigate clinical efficacy and safety of Qili qiangxin capsule combined with routine treatment (combined treatment group)versus routine treatment (routine treatment group )in the treatment of chronic heart failure. From the perspective of Chinese health care system ,a decision tree model was constructed. The time horizon of the model was 1 year. The effective rate obtained by meta-analysis was taken as the effect parameter ,and the total cost was calculated by drug cost and hospitalization cost ,to evaluate the cost-effectiveness of combined treatment versus routine treatment in the treatment of chronic heart failure. Subgroup analysis was carried out according to the course of treatment and literature quality ,and one-way sensitivity analysis and probability sensitivity analysis were adopted to check the robustness of basic analysis results. RESULTS Total of 72 literatures involving 9 575 patients were included in meta-analysis. Results of meta-analysis showed that effective rate ,left ventricular ejection fraction , N-terminal fragment of the prohomone brain-type natriuretic peptide and 6 minute walking distance in combined treatment group were all better than those of routine treatment group , while its safety was similar to routine therapy. The results of cost-effectiveness analysis showed that the cost of combined therapy was 1 867 yuan higher than that of routine therapy ,patients could get 0.016 QALYs more ,and the incremental cost-effectiveness ratio (ICER)was 117 861 yuan/QALY. If only high-quality literature were included for meta-analysis and the effectiveness parameters were obtained ,the ICERs of the combined therapy versus routine therapy were 102 162 yuan/QALY(based on all high-quality literature )and 72 354 yuan/QALY(based on high-quality literature with treatment course of 24 weeks). The results of the probability sensitivity analysis showed that taking twice China ’s per capita gross domestic product in 2020 as the willingness to pay threshold ,the probability of cost-effectiveness for Qili qiangxin capsule combined with routine therapy was 67.1% . CONCLUSIONS Compared with routine therapy ,Qili qiangxin capsule combined with routine therapy has better clinical efficacy ,equivalent safety and cost-effective.