| Objectiives:Based on the perspective of patients,a retrospective pharmacoeconomics analysis was carried out on two groups of different drug regimens of type 2 diabetic patients with peripheral neuropathy in a three-grade hospital in Beijing.Under the circumstances that the baseline data of the two groups of treatment plans are not uniform,the connotation of the incremental cost-effectiveness ratio is decomposed,and the net benefit regression framework in the econometric model is introduced to construct the retrospective cohort study based on the actual outcome.The Pharmacoeconomics Evaluation Framework of World Research and Design provides methodological support for further comparing the economics of the two groups.At the same time,it could provide evidence-based references for type 2 diabetic patients to choose a cost-effective treatment plan,and also can provide a reference for the rational allocation of medical resources in the field of diabetes drug treatment.Methods:This study is a retrospective cohort study.Firstly,the literature research method was used to conduct a comprehensive search and sorting of related literature from 2007 to 2018,in order to master the clinical features,clinical medications,and therapeutic effects of the disease.Secondly,experts consulted with clinical,evidence-based medicine,pharmacy,pharmacoeconomics,statistics,and other relevant experts to communicate and conduct interviews to formulate case selection criteria for inclusion of exclusion criteria and drug plans.Then,we can use the field survey method to obtain cost and effect data and quantify the data,and perform statistical analysis on the baseline data.Use the net benefit as the dependent variable,the effect index as the independent variable,and the baseline relevant variable as the covariate to introduce the net benefit regression framework to conduct a net benefit analysis.Contents:The first step is to screen and collect data on the cases of inpatients from the endocrine department of a top-level hospital in Beijing from January 2014 to December 2017.The baseline indicators,medication and treatment status,and efficacy indicators after the use of medications are grouped into EXCEL after arranging.Secondly,we should try to test whether the baseline indicators are neat,and quantify the cost and effect indicators.Then,cost-effectiveness analysis and sensitivity analysis were performed to compare the differences in the economic results of the two oral hypoglycemic agents.Under the condition that the baseline indicators are inconsistent,the patient willingness to pay value is introduced.The research used regression model to construct an econometric model with net benefits as output.The economic differences between the two groups of different drug treatment plans are compared and the patient's willingness to pay is paid.Values were correlated with statistical analysis to determine the critical value of patient willingness to pay and the credibility of the decision,and to draw a cost-effectiveness-acceptable curve.Results:1.In the statistical analysis of baseline data,the demographics of the patients in the two groups of treatment programs were not equalized.2.According to the quantification of cost and effect indicators,the scores of Toronto clinical scores after treatment in both groups A and B were significantly lower than those before treatment.The total treatment efficiency of group A was higher than that of group B.The average cost of group A was higher than that of group B.3.In the cost-effectiveness analysis,the cost-effectiveness ratio of group A was 7.42,the cost-effectiveness ratio of group B was 7.49,the cost-effectiveness ratio between group A and group B was 3.48,indicating that patients in group A had to pay 3.48 units more to obtain a unit of health than group B;after sensitivity analysis,the result is consistent with the original.4.Based on situations that the demographics data is inconsistency,considering all confounding factors as covariates,net benefit as independent variable,and affect index as dependent variable,introduction of patient willingness to pay value,and construct a net benefit regression model.5.The statistical results show that if the patient's willingness to pay is greater than 947.32 yuan,the net benefit from the treatment of group A is greater.If the patient's willingness to pay is less than 947.32 yuan,the net benefit from the treatment of group B is greater.6.According to the analysis of the patient's willingness to pay:when 0<?<255,it can be more convinced(greater than 99.35%)that group B treatment is more economical.When 255<?<947.32,it can be considered that the B regimen is more economical,but not very certain(less than 99.35%).When 947.32<?<1000it can be considered that the A regimen is more economical,but not very certain(less than 99.35%).When ?>1 000,it is more convinced(greater than 99.35%)that group A treatment regimens are more economical.Conclusions:According to the cost-effectiveness analysis results of the two groups of patients,from the effect index,the treatment effect of group A was better.From the treatment efficiency point of view,group A drug treatment is more efficient.However,from the perspective of incremental cost-effectiveness ratio analysis,compared with group B,the incremental cost-effectiveness ratio of group A treatment plan is lower than the cost-effectiveness ratio of group B treatment plan.Therefore,from the aspect of cost-effectiveness analysis,the selection of group A is more reasonable and economical.In the two groups of patients,the net-benefit-regression analysis results were greatly affected by the maximum willingness to pay and related confounding factors.With the value gradually increasing,the net benefits of the two groups of A and B treatment programs were also changed accordingly.Therefore,for patients with a lower maximum willingness to pay,it is more economical to choose a group B treatment plan;for patients with a higher maximum willingness to pay,it is more economical to choose a group A treatment plan. |
PDF Full Text Request