| Objective To compare Oxycodone hydrochloride prolonged-release tablets and Morphine sulfate sustained-release tablets’ clinical curative effect, safety and economy in treating cancer pain, and provide evidence-based evidence for rational drug use.Method 1. Retrieve the English database of MEDLINE, EMBASE, Pub Med, the Cochrane library; Chinese National Knowledge Infrastructure(CNKI), Wanfang digital journals library, Chinese science and technology journal full-text database(Cq Vip). Collected randomized controlled trial(RCT) about Oxycodone hydrochloride prolonged-release tablets and Morphine sulfate sustained-release tablets treating cancer pain at home and abroad, analysis indicators for treatment efficient and incidence of adverse reactions. According to the Cochrane system evaluation method screening test, evaluation of quality, the data extracted, Meta-analysis using Rev Man 5.2 software. According to the different way of scoring, they were divided into two subgroups of NRS and VAS, Meta-analysis to the curative effect of Oxycodone hydrochloride prolonged-release tablets and Morphine sulfate sustained-release tablets treating cancer pain. Using the funnel figure qualitative method, Stata software Egger’s quantitative method and sensitivity analysis method to evaluate bias. 2. Through comparative research method, model analysis and the study of literature, using Tree Age pro 2011 software, set up basic model framework suitable for pharmaco-economics evaluation of patients with cancer pain. Calculation results using the model framework, and the various aspects make assumptions that may influence the results and sensitivity of analysis.Result 1. The participants included 1209 cases of 15 RCT studies, the effective rate of Oxycodone hydrochloride prolonged-release tablets and Morphine sulfate sustained-release tablets treating cancer pain, NRS group’s results were 86.3% and 86.3% respectively(P=0.28); VAS group’s results were 92.6% and 89.6% respectively(P=0.31). For the incidence of constipation, Oxycodone hydrochloride prolonged-release tablets is lower than Morphine sulfate sustained-release tablets by 10.1%(P=0.002). 2. Cost effect analysis results suggest, for the current Chinese health insurance, according to the current drug pricing, cancer pain choosing Oxycodone hydrochloride prolonged-release tablets has no cost effect. However, for per capita GDP more than ￥69593, Oxycodone hydrochloride prolonged-release tablets treating cancer pain may have cost effect.Conclusion 1. Oxycodone hydrochloride prolonged-release tablets and Morphine sulfate sustained-release tablets treating cancer pain have similar curative effect. 2. From the perspective of China’s medical and health system, the choice of Oxycodone hydrochloride prolonged-release tablets treating cancer pain has no cost effect. However, in some places with higher per capita GDP, choosing Oxycodone hydrochloride prolonged-release tablets treating cancer pain may have cost effect. 3. Decision tree model as an important tool for decision analysis, can be widely used in the study of pharmacoeconomics evaluation. |
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