Cost-Benefit Analysis of Bacterial Lysates for Chronic Obstructive Pulmonary Disease in China

目的：探讨细菌溶解产物在预防慢性阻塞性肺疾病（COPD）急性发作中的成本-效益。方法使用成本-效益分析法，对象为接受细菌溶解产物治疗的COPD患者，成本为通过德尔菲法获得单次治疗COPD急性发作的医疗费用，效果指标为通过荟萃分析得到的随访期为12个月内患者COPD急性发作次数。使用单因素敏感性分析对参数变化对结果的影响进行识别。结果在对COPD的常规治疗中加入细菌溶解产物制剂能明显降低COPD患者12个月内的急性发作次数，降低患者的医疗负担，敏感性分析显示这一结果稳健。相比于单用常规治疗的患者，加用细菌溶解产物的患者平均少1.9次COPD急性发作，平均节省医疗费用14476元。结论对于COPD患者，在治疗中使用细菌溶解产物能减少急性发作次数，降低患者医疗费用。Objective The purpose of this study was to conduct a cost-benefit analysis of bacterial lysates from a payer perspective through the results from a Meta analysis and a Delphi panel survey in China.Methods A cost-benefit analysis was to project the 12-month health benefits and costs associated with immune stimulation treatments. Acute exacerbations were served as a measure of effectiveness. Treatment effectiveness data were derived from the meta-analysis. Costs were obtained from a Delphi panel survey of treating acute exacerbation for chronic obstructive pulmonary disease in China.Results The group receiving routine care only was dominated by the group with bacterial lysates plus routine care. Sensitivity analysis proved the robustness of the results. For a COPD patient, compared to the routine care as control group, the alternative treatment with bacterial lysates could reduce 1.9 exacerbations in 12 months. The projected 12-month cost savings of a patient receiving bacterial lysates plus routine care was CNY14 476.The cost of patients receiving bacterial lysates plus routine care was significantly lower than those receiving routine care only.Conclusion For patients with COPD, treatments with bacterial lysates can improve patient outcomes and reduce costs.0119-11,1