奥昔布宁与肉毒杆菌毒素 A (Botox) 治疗膀胱过度活动症的成本效用分析,International Journal of Environmental Research and Public Health

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奥昔布宁与肉毒杆菌毒素 A (Botox) 治疗膀胱过度活动症的成本效用分析
International Journal of Environmental Research and Public Health Pub Date : 2021-08-19 , DOI: 10.3390/ijerph18168743
Habiba Shabir ₁ , Sana Hashemi ₁ , Moussa Al-Rufayie ₁ , Tayo Adelowo ₁ , Umar Riaz ₁ , Umayair Ullah ₁ , Benyamin Alam ₂ , Mehreen Anwar ₁ , Laure de Preux ₃

Affiliation

背景：英国国民健康服务 (NHS) 建议在治疗膀胱过度活动症 (OAB) 之前先使用奥昔布宁，然后再使用肉毒杆菌毒素 A (Botox)。奥昔布宁价格昂贵且依从性差，而肉毒杆菌可能不会发生这种情况。我们进行了成本效用分析 (CUA) 来比较药物。方法：我们从 NHS 的角度比较了质量调整生命年 (QALYS) 中的两种治疗方法。成本来自英国的来源并已打折。通过将每个分支的并发症的治疗成本和管理成本相加来确定总成本。使用 12 个月的时间框架将数据建模为决策树。结果：我们的结果发现，使用肉毒杆菌素一线比奥昔布宁具有更高的成本效用。健康净收益计算显示，当一线使用肉毒杆菌素时，QALYs 增加了 0.22。除了儿科患者的 ICER 为 42,272.14 英镑，高于 NICE 的 30,000 英镑阈值外，肉毒杆菌素还具有更高的成本效益。结论：在成人 OAB 的管理中，肉毒杆菌素被发现比抗毒蕈碱药物更具成本效益，但在年轻患者中的成本效益较低。这预示着需要进一步研究以确定肉毒杆菌毒素在 OAB 管理中变得具有成本效益的年龄。

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Cost-Utility Analysis of Oxybutynin vs. OnabotulinumtoxinA (Botox) in the Treatment of Overactive Bladder Syndrome

Background: The UK National Health Service (NHS) propose the use of oxybutynin prior to onabotulinumtoxinA (Botox) in the management of overactive bladder syndrome (OAB). Oxybutynin is costly and associated with poor adherence, which may not occur with Botox. We conducted a cost-utility analysis (CUA) to compare the medications. Methods: we compared the two treatments in quality-adjusted life years (QALYS), through the NHS’s perspective. Costs were obtained from UK-based sources and were discounted. Total costs were determined by adding the treatment cost and management cost for complications on each branch. A 12-month time frame was used to model the data into a decision tree. Results: Our results found that using Botox first-line had greater cost utility than oxybutynin. The health net benefit calculation showed an increase in 0.22 QALYs when Botox was used first-line. Botox also had greater cost-effectiveness, with the exception of pediatric patients with an ICER of £42,272.14, which is above the NICE threshold of £30,000. Conclusion: Botox was found to be more cost-effective than antimuscarinics in the management of OAB in adults, however less cost-effective in younger patients. This predicates the need for further research to ascertain the age at which Botox becomes cost-effective in the management of OAB.

更新日期：2021-08-19

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