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Objective To evaluate the application of multiattribute utility theory(MAUT) in pharmacoeco-nomic evaluation of anti - inflammatory and hepatoprotective therapy for chronic hepatitis B ( CHB). Methods During year 2014 - 2016,214 patients with mild to moderate CHB were selected. The patients were divided into three groups: A,B and C according to the therapeutic regimen,and they were given compound glycyrrhizin,tiopronin and polyene phosphatidylcholine to prevent inflammation and protect liver. MAUT model was constructed,the evaluation factors were determined and appropriate weight was given to each element parameter,the specific utility values for each factor were calculated,and by calculating the total utility value of final results quantitatively demonstrated the three regimens in the treatment of chronic hepatitis B. Results The total effective rates of A,B,C three groups were 78. 38％ ,69. 44％ ,79. 41％ ,respectively,the difference was statistically significant( χ2 = 5. 559,P < 0. 05). The incidence rates of adverse reaction of A,B,C three groups were 16. 22％ ,8. 33％ ,5. 88％ ,respectively. As to direct cost,group B(1430. 45 yuan) was better than group C(1494. 04 yuan) and group A (1515. 92 yuan). The hospital days of A,B,C three groups were (11. 3 ± 4. 8) d,(10. 9 ± 10. 6) d,(12. 5 ± 6. 4) d,respectively. The results of MAUT comprehensive evaluation showed that the total score value in polyene phosphatidylcholine group was the highest,and was the optimal treatment in the study. Conclusion Application of MAUT in the study of pharmacoeco-nomics is comprehensive,intuitive and flexible.
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To establish the control model of medical insurance in hospitals, so as to improve the effectiveness of internal operation for medical insurance fund. Methods: Using the utility theory to establish the control model, with which the medical service provider is individual rationality constraints and incentive compatibility constraint. Results: The bonus coefficient and punishment coefficient can be calculated by means of evolutionary programming. Conclusion: The control model of hospital internal medical insurance fund is useful in controlling the medical insurance expense, it also provides the guidance and references for performance management and internal operation.
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Objective: Drugs for hepatoprotection and enzymes reduction are widely used in China but their economic analysis has been ignored in a rather long period of time. A suitable protocol for hepatoprotection and enzymes reduction was recommended in Longhua Hospital. Methods: This study was conducted as a retrospective piece. Three therapeutic protocols (compound glycyrrhizic glycoside combined with aspartic ornithine injection, compound glycyrrhizic glycoside combined with phosphatidylcholine, and compound glycyrrhizic glycoside combined with tiopronin) were selected. Seventy inpatient cases from January 2011 to February 2012 were enrolled and divided into three groups according to different regimens. The cost effectiveness of the three groups was respectively evaluated by incremental cost-effectiveness ratios (ICERs). A decision tree model and multi attribution utility theory were also adopted to analyze the data. Results: All the three regimens exhibited good effects on protecting liver functions and reducing the levels of enzymes. Among them, the protocol of compound glycyrrhizic glycoside combined with tioproni expressed the least ICER, the lowest cost but the highest score in the multi-utility. Conclusion: The therapeutic method of compound glycyrrhizic glycoside combined with tiopronin is the most cost-effective option in this study.