强阿片类药物对比弱阿片类药物治疗中度癌痛的决策树分析

Decision-Making Tree Analysis of the Strong Opioid Drug Versus the Weak Opioid Drug for Treating Moderate Cancer Pain

关键词:  羟考酮缓释片  曲马多缓释片  药物经济学  癌痛  决策树  成本效果

Key words:  oxycodone  tramadol  pharmacoeconomics  cancer pain  decision tree  cost-effectiveness

摘要:

目的 利用决策树模型进行强阿片类药物羟考酮与弱阿片类药物曲马多治疗中度癌痛的成本效果分析。方法 检索相关随机对照研究，通过meta分析得出羟考酮及曲马多治疗中度癌痛的有效率、不良反应发生率，通过treeage决策软件进行成本效果分析。结果 羟考酮相比曲马多，增量成本效果比（incremental cost-effectiveness ratio，ICER）为每人458.89元，敏感性分析显示决策树模型稳定。结论 ICER<3倍人均GDP，羟考酮治疗增加的成本可以接受，在中国人群中治疗中度癌痛羟考酮比曲马多成本效果更佳。

Abstract:

OBJECTIVE To evaluate cost-effectiveness of the strong opioid drug oxycodone and the weak opioid drug tramadol for treatment of moderate cancer pain patients by decision tree model. METHODS A meta-analysis of related randomised controlled clinical trials that were retrieved in medical databases to obtain effective rate and adverse effects rate. Cost-effectiveness analysis was performed with decision tree model that was created by treeage software. RESULTS In contrast with tramadol, incremental cost-effectiveness ratio (ICER) of oxycodone group was RMB 458.89 every person. Sensitivity analysis showed that the results were stablely. CONCLUSION ICER<3 times GDP per capita, the cost of oxycodone treatment is acceptable. In contrast, cost effectiveness of oxycodone is more than tramadol for treating moderate cancer pain in Chinese population.