罗浮山风湿膏药治疗类风湿关节炎的药物经济学评价OA

Objective To evaluate the treatment of rheumatoid arthritis(RA)with Luofushan rheumatic plaster in economics,and to provide basis for the selection of national medical insurance drug list,essential drug list and drug price.Methods Based on multicenter randomized double-blind controlled clinical trial data of the Luofushan Rheumatism Plaster Patch,along with Drug Intelligence Network(DI-net)data and publicly available literature,a decision tree(at 4 weeks and 8 weeks)and a Markov model(over 20 years)were developed.The intervention group received the Luofushan Rheumatism Plaster Patch in combination with foundational therapy,while the control group received foundational therapy alone.The study focused on the perspective of healthcare payers.Health outcomes were assessed based on the reduction in visual analog scale(VAS)score at week 8,quality-adjusted life-days(QALDs),and quality-adjusted life-years(QALYs).Costs included direct medical costs,with a willingness-to-pay threshold set at three times the per capita gross domestic product(GDP)for the year 2022.Sensitivity analyses,including univariate and probabilistic analyses,were conducted to assess the robustness of the base analysis.Results The cost-effectiveness analysis results of the reduction in VAS score at week 8 showed that the incremental cost-effectiveness ratio(ICER)of the Luofushan group compared to the control group was 3.02 yuan(approximately 0.000 1 times the per capita disposable income in 2022).The decision tree analysis results at week 4 and week 8 demonstrated that the ICER for the Luofushan group compared to the control group was 25.71 yuan/QALD and 16.59 yuan/QALD,respectively.Based on the threshold(2022 per capita GDP divided by 365 days = 234.79 yuan/day),the additional costs were considered worthwhile.The Markov model analysis revealed an ICER of 52 107.21 yuan/QALY for the Luofushan group compared to the control group.According to the threshold,the increased costs were deemed justified.Conclusion Compared with RA basic treatment,Luofushan rheumatism plaster combined with RA basic treatment is a program with higher cost and more benefits.Judging from the threshold value,the increased cost is worthwhile and has economic advantages.