Pharmacoeconomics of three Therapeutic Schemes for Anti-tuberculosis Therapy Induced Liver Injury in China

Abstract

To evaluate the pharmacoeconomics of three therapeutic schemes in treating anti-tuberluosis therapy -induced liver injury (anti-TB DILI).

Methods: In the construction of a decision tree model, the efficacy and safety parameters came from the results of the randomized, controlled trial conducted here, the effect parameters were derived from expert advice, and the cost parameters, such as usage specification, number, and unit price, came from literature, expert advice, and so on.

Results: The cost-effectiveness analysis (CEA) based on the effect degrees showed that bicyclol had the best effect (4.63562). The incremental cost-effectiveness ratio (ICER) (206.03270) of bicyclol was the lowest. The cost-effectiveness ratio of silibinin was the lowest (68.59987). The CEA based on the complete normalization rate showed that bicyclol had the highest complete normalization rate (83.562%), the lowest cost-effectiveness ratio (4.63627), and the smallest ICER (4.63504). Sensitivity analyses proved the robustness of the results.

Conclusions: Bicyclol is the most cost-effective therapy and the preferred choice for treating anti-TB DILI.

Keywords: Anti-TB DILI; Cost-effectiveness analysis; Decision trees analysis; Pharmacoeconomics; Prospective.

Figure 1

Decision tree model structure The decision node is represented with “□” and it is the starting point of the decision problem. The state point is represented with “O,” indicating the status that the scheme has met with. The lines drawn from the state point indicate a variety of possible states that may occur; next to them, all status contents are marked, and the degree of possibility for development is expressed by probability. The terminal point of decision is expressed by “Δ,” next to which the assigned value of each effect degree is marked.

Figure 2

Cost-effectiveness frontier