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目的:运用药物经济学评价的方法,对利培酮、奥氮平、喹硫平、齐拉西酮、阿立哌唑5种药品一线治疗首发精神分裂症进行成本效果分析,为临床治疗首发精神分裂症用药提供参考和建议。方法:通过单组率Meta分析获得有效率指标,对5种药品治疗首发精神分裂症构建决策树模型进行成本效果分析,并进行单因素敏感性分析和概率敏感性分析。结果:通过增量成本效果分析,喹硫平、奥氮平、阿立哌唑为劣势方案被排除;齐拉西酮相比于利培酮的增量成本效果比(incremental cost effectiveness ratio,ICER)为25 194.09元。敏感性分析与基础分析结果基本一致。结论:临床治疗首发精神分裂症时可以根据患者的意愿支付值(willingness-to-pay,WTP)选择最优方案。若WTP低于ICER,则优先使用利培酮;若高于ICER,则优先使用齐拉西酮。但就我国国情而言,ICER值相对较高,利培酮对绝大多数中国患者更具有经济性,推荐临床优先使用。
OBJECTIVE: To evaluate the cost-effectiveness of the first-line schizophrenia treatment with risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole in the first-line treatment of schizophrenia by using the method of pharmacoeconomic evaluation Schizophrenia medication for reference and advice. Methods: According to the single-group meta-analysis, the efficiency indexes were obtained, and the cost-effectiveness analysis of 5 drug-treatment decision tree models for the first episode of schizophrenia was carried out. Single-factor sensitivity analysis and probability sensitivity analysis were carried out. Results: According to incremental cost-effectiveness analysis, quetiapine, olanzapine and aripiprazole were excluded as inferiority programs; the incremental cost effectiveness ratio of ziprasidone vs risperidone (ICER ) Was $ 25,194.09. Sensitivity analysis and basic analysis results are basically the same. CONCLUSIONS: In clinical treatment of first-episode schizophrenia, the optimal program can be selected according to the willingness-to-pay (WTP) value of the patient. If WTP is lower than ICER, risperidone is preferred; if it is higher than ICER, ziprasidone is preferred. However, in terms of our national conditions, ICER value is relatively high, risperidone for the vast majority of Chinese patients more economical, recommended clinical priority.