Cost Effectiveness Analysis Of New Pharmacoeconomic Evaluation Method Based On Bayesian Inference For The Treatment Of Chronic Obstructive Pulmonary Disease

Objective: The purpose of this study is to use Revman 5.3 software and WinBUGS software,try to combine the Bayesian model with the meta-analysis method introduced in the Cochrane Handbook of systematic evaluation of interventions,through the collection of relevant treatment information of COPD patients,predict the difference of efficacy between different interventions in stable COPD,and analyze the economics of six kinds of COPD drugs,to explore the differences,To provide a reference for the effectiveness and economic evaluation methods of various kinds of respiratory diseases drugs in the future,and guide the clinical rational drug use.Method: The published literatures on the treatment of COPD were searched and collected.The quality of COPD was evaluated by the evaluation method provided by Cochrane Collaboration Network.With the help of Revman 5.3 software and Win BUGSsoftware,Bayesian method with non-prior information was used to evaluate the effects of different drugs for COPD by different statistical methods(random effect model / fixed effect model),and the economic differences were analyzed by combining with Pharmacoeconomics theory.Result: Through the retrieval of CNKI,VIP,Wanfang Data knowledge service platform and other databases,a total of 38 articles were included in the research and analysis,and the effect was analyzed by using Bayesian method.Taking the effective rate as the effect index,the results showed that Seretide + Aminophylline regimen had the highest effective rate,rat[5]=96.58%,followed by Seretide + Tiotropium Bromide,rat[2]=94.82%,Budesonide Formoterol + Tiotropium Fromide,rat[6]=94.70%.The order of medication economy was Seretide + Aminophylline > Doxofylline + Tiotropium Bromide > Seretide + Tiotropium Bromide > Budesonide Formoterol + Tiotropium Bromide > Terbutaline + Glucocorticoid.Taking forced expiratory volume in the first second(FEV1)as the effect index,the results showed that budesonide formoterol + tiotropium bromide had the best effect in improving lung function,dif[11,12]=0.9912,followed by Boxofylline + Tiotropium Bromide,dif[7,8]=0.7516,Seretide + aminophylline,dif[9,10]=0.7312.The economic order of drug use was Seretide + Aminophylline > Doxofylline + Tiotropium Bromide > Budesonide Formoterol + Tiotropium Bromide > Compound Danshen Dripping Pills + Anti-inflammatory Drugs > Seretide + Tiotropium Bromide.When forced vital capacity(FVC)was used as the effect index,the results showed that Budesonide Formoterol + Tiotropium Bromide had the best effect on improving lung function,dif[11,12]=0.7157.The order of medication economy was budesonide Formoterol + Tiotropium Bromide > Doxofylline + Tiotropium Bromide > Seretide + Tiotropium Bromide.Taking FEV1/FVC as the effect index,the results showed that Budesonide Formoterol + Tiotropium Bromide had the best effect on improving lung function,dif[11,12]=18.4,followed by Seretide + Aminophylline,dif[9,10]=16.29.The order of medication economy was Seretide + Aminophylline > Budesonide Formoterol + Tiotropium Bromide > Doxofylline + Tiotropium Bromide > Seretide + Tiotropium Bromide > Compound Danshen Dripping Pills + Anti-inflammatory Drugs.Conclusion: When Bayesian method is used to compare the therapeutic effects of different schemes,Win BUGS software can use non prior information to control the posterior distribution and ensure the comprehensiveness and objectivity of the analysis.Therefore,the subjective influence of prior information in the algorithm is greatly reduced,and the more effective probability of some intervention measures is obtained.The results showed that Seretide + Aminophylline had obvious economic advantages in the effective rate and lung function improvement.However,from the perspective of therapeutic effect,the combination of Budesonide Formoterol + Tiotropium Bromide has the best effect.Patients can choose budesonide,formoterol and tiotropium bromide for maintenance treatment of COPD in stable stage when economic conditions permit.