对辅助重复性横性磁性刺激用于治疗耐药双极性抑郁症的成本效益分析

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Mary Lou Chatterton¹, Yong Yi Lee², Long Khanh-Dao Le³

¹School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Institute for Health Transformation, Deakin University, Geelong, Australia.

Journal of affective disorders

|April 24, 2024

概括

重复性跨磁刺激 (rTMS) 是澳大利亚治疗耐药双极性抑郁症 (TRBD) 标准护理的经济有效补充. 它提供了显著的价值,特别是在考虑质量调整后获得的寿命时.

科学领域:

卫生经济学卫生经济学
神经科学是一个神经科学.
精神病学是一个精神病学.

背景情况:

治疗耐药双极性抑郁症 (TRBD) 在精神卫生保健中构成了重大挑战.
标准护理本身往往会给TRBD患者带来不理想的结果.
重复性跨脑磁性刺激 (rTMS) 是一种新兴的神经调节技术.

研究的目的:

评估RTMS作为澳大利亚TRBD辅助治疗的成本效益.
为了比较rTMS加标准护理与单独标准护理的经济价值.
为了确定每种残疾调整寿命年 (DALY) 的成本,避免和质量调整寿命年 (QALY) 获得.

主要方法:

一个经济模型在一年内模拟了患者的健康状况 (躁狂,抑郁,残留).
来自元分析的rTMS反应率被用来调整在抑郁状态中花费的时间.
进行了不确定性和灵敏性分析,以验证模型的稳定性.

主要成果:

基本情况的增量成本效益比率 (ICERs) 避免了72,299美元/DALY,并获得了46,623美元/QALY.
在支付意愿的门上,rTMS显示出100%的成本效益概率.
敏感性分析表明,通过减少rTMS会话或调整健康状况参数,成本效益有所提高.

结论:

rTMS是TRBD的成本有效或边际成本有效的辅助疗法.
rTMS的经济价值取决于所选择的结果测量和模型假设.
这些发现支持将rTMS纳入澳大利亚医疗保健系统中TRBD的标准护理.

关键词:

双极性障碍是一种双极性障碍.抑郁症抑郁症抑郁症卫生经济学卫生经济学健康结果的健康结果.心理健康心理健康情绪障碍情绪障碍情绪障碍精神病学是一个精神病学.

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