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聚异丁烯型骨通贴膏用于中国成人骨关节炎的有效性、安全性和

          经济性
                     Δ


          经天宇 ,刘朝一,刘海娇,钟港棚,黄晓青,徐 伟(中国药科大学国际医药商学院,南京 211198)
                *
                                                       #
          中图分类号  R956;R684.3      文献标志码  A      文章编号  1001-0408(2023)12-1478-05
          DOI  10.6039/j.issn.1001-0408.2023.12.13


          摘   要  目的  评估聚异丁烯(PIB)型骨通贴膏(简称“PIB骨通贴膏”)对比非甾体抗炎药(NSAIDs)用于中国骨关节炎成人患者
          的有效性、安全性和经济性。方法  基于一项真实世界研究数据,采用倾向评分匹配后,评估PIB骨通贴膏对比3种NSAIDs(塞来
          昔布、双氯芬酸钠、布洛芬)的疼痛视觉模拟(VAS)评分的下降值、健康效用增加值、疼痛消失时间、关节活动度复常时间以及总不
          良事件发生情况;采用成本-效用分析法,从全社会角度计算患者使用PIB骨通贴膏相对3种NSAIDs的增量成本-效果比(ICER),
          并进行敏感性分析。结果  有效性方面,PIB骨通贴膏组患者的关节活动度复常时间显著长于塞来昔布组,VAS评分下降值显著
          大于布洛芬但显著小于双氯芬酸钠,疼痛消失时间显著长于双氯芬酸钠组与布洛芬组,健康效用增加值显著低于双氯芬酸钠组
         (P<0.05)。安全性方面,PIB骨通贴膏患者的总不良事件发生率及不良事件严重程度与3种NSAIDs比较,差异均无统计学意义
         (P>0.05)。经济性方面,与塞来昔布、双氯芬酸钠比较,PIB骨通贴膏为绝对劣势方案;与布洛芬比较,ICER值为178 611.58元/
          QALY,即现有价格下,若以3倍人均国内生产总值为阈值,PIB骨通贴膏方案具有经济性。敏感性分析结果与基础分析结果一致。
          结论  PIB 骨通贴膏用于我国骨关节炎患者短期治疗的疗效优于布洛芬,与塞来昔布相当,但不及双氯芬酸钠,安全性与 3 种
          NSAIDs一致,其经济性还有待提高。
          关键词  骨通贴膏;非甾体抗炎药;疗效;安全性;成本-效用;真实世界

          Efficacy,  safety  and  cost-effectiveness  of  polyisobutylene-type  Gutong  plaster  in  the  treatment  of  osteoarthritis
          in Chinese adults
          JING Tianyu,LIU Chaoyi,LIU Haijiao,ZHONG Gangpeng,HUANG Xiaoqing,XU Wei(School of International
          Pharmaceutical Business, China Pharmaceutical University, Nanjing 211198, China)

          ABSTRACT    OBJECTIVE  To  evaluate  the  efficacy,  safety  and  cost-effectiveness  of  polyisobutylene (PIB)-type  Gutong  plaster
         (called “PIB Gutong plaster” for short) versus non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis in
          Chinese  adults.  METHODS  Based  on  a  real-world  study,  after  propensity  score  matching,  the  decrease  in  pain  visual  simulation
          score,  utility  increase,  time  to  pain  resolution,  time  to  return  to  normal  range  of  motion  and  total  adverse  events  of  PIB  Gutong
          plaster  versus  three  NSAIDs (celecoxib,  diclofenac  sodium,  and  ibuprofen)  were  evaluated.  Cost-utility  analysis  was  used  to
          calculate  the  incremental  cost-effectiveness  ratio (ICER)  of  patients  using  PIB  Gutong  plaster  versus  the  three  NSAIDs  from  the
          perspective of the whole society, and sensitivity analysis was carried out. RESULTS In terms of effectiveness, the recovery time of
          joint activity in PIB Gutong plaster group was significantly longer than that in celecoxib group, the decrease in VAS score of PIB
          Gutong  plaster  was  significantly  higher  than  that  of  ibuprofen  but  significantly  lower  than  that  of  diclofenac  sodium;  the  time  of
          pain  disappearance  was  longer  than  that  in  diclofenac  sodium  group  and  ibuprofen  group,  and  the  increase  in  health  utility  was
          significantly lower than that in diclofenac sodium group (P<0.05). In terms of safety, there were no significant differences in the
          incidence  and  severity  of  adverse  events  of  PIB  Gutong  plaster,  compared  with  the  three  NSAIDs,  without  statistical  significance
         (P<0.05).  In  terms  of  cost-effectiveness,  compared  with  celecoxib  and  diclofenac  sodium,  PIB  Gutong  plaster  was  dominant.
          Compared with ibuprofen, the ICER value of PIB Gutong plaster was 178 611.58 yuan/QALY, indicating that at the current price,
          PIB Gutong plaster was cost-effective if the threshold was 3 times GDP per capita. The results of sensitivity analysis were consistent
          with those of basic analysis. CONCLUSIONS The efficacy of PIB Gutong plaster was better than that of ibuprofen, similar to that
                                                              of  celecoxib,  but  worse  than  that  of  diclofenac  sodium,  the
              Δ 基金项目 药物临床综合评价研究技术服务项目(No. 技合
                                                              safety  was  consistent  with  the  three  NSAIDs,  and  the  cost-
          2021-商003)
             *第一作者 硕士研究生。研究方向:医疗保险、药物政策、药物经                   effectiveness of PIB Gutong plaster  needs to be improved.
          济学。E-mail:jty_work@163.com                          KEYWORDS    Gutong  plaster;  non-steroidal  anti-inflamma-
              # 通信作者 教授,博士生导师,博士。研究方向:医疗保险、药物                 tory drugs; efficacy; safety; cost-utility; real world
          政策、药物经济学。E-mail:xuwei@cpu.edu.cn


          · 1478 ·    China Pharmacy  2023 Vol. 34  No. 12                            中国药房  2023年第34卷第12期
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