新加坡良性前列腺增生症的替代一线和二线治疗方法的成本效益
Junxing Chay1, Joshua Yi Min Tung2, Rebecca Jade Su1
1Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Journal of medical economics
|October 6, 2023
概括
与医疗管理 (MM) 相比,水蒸气热疗法 (WVTT) 是良性前列腺增生 (BPH) 的成本效益高的第一线治疗方法. 前列腺尿道提升 (PUL) 不具有成本效益,而 TURP 对严重的BPH具有成本效益.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
背景情况:
- 像水蒸气热疗法 (WVTT) 和前列腺尿道升高 (PUL) 这样的最小侵入性手术疗法是医疗管理 (MM) 失败后前列腺经尿道切除 (TURP) 的替代方案.
- 作为良性前列腺增生症 (BPH) 的初始或后续治疗方法,WVTT和PUL的增量成本效益尚不清楚.
研究的目的:
- 评估新加坡中度至重度BPH各种一线和二线治疗策略的增量成本效益.
- 为决策者提供基于不同BPH治疗的金钱价值的补贴决定的信息.
主要方法:
- 一个马尔科夫队列模型模拟了六种加强的治疗策略,从MM,WVTT,PUL或TURP开始.
- 该模型追踪了BPH严重程度状态和再治疗之间的过渡,在整个生命周期内计算成本和质量调整的寿命年 (QALYs).
主要成果:
- 对于中度BPH,一线WVTT与MM (33,307 SGD/QALY) 相比,成本效益增加. 第一线的 TURP 与 WVTT 相比没有成本效益.
- 对于严重的BPH,WVTT与MM (30,133 SGD/QALY) 和 TURP作为二线治疗 (6877 SGD/QALY) 相比具有成本效益. 在严重的BPH患者 (48,209名SGD/QALY) 中,一线TURP具有成本效益.
- 所有涉及PUL的治疗途径都占主导地位,显示了更高的成本和更低的QALY.
结论:
- 与MM相比,WVTT作为中度或重度BPH的第一线治疗方法具有成本效益,代表了良好的金钱价值,并证明了补贴考虑的合理性.
- 作为BPH的第一或二线治疗方法,PUL是不具有成本效益的.
- 作为一线治疗,TURRP对于患有严重BPH的患者来说也是具有成本效益的.
关键词:
良性前列腺增生症 良性前列腺增生症D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D 在线观看 在线观看 在线观看D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D6 D7 D7 D7 D8 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D9 D1 D1 D1 D1 D1 D1D61 D61 D61 D61 这是一个很好的例子.我已经开始了,我已经开始了.第111章 这是一件好事在I1818年,马尔科夫模型的模型经济评估 经济评价增量性成本效益比率是一个增量性成本效益比率.水蒸气热疗法是一种水蒸气热疗法.相关概念视频
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