Application Research Of Budget Impact Analysis In The Selection Of Medical Insurance Drug List For Unstable Angina Pectoris

Objective:Taking six interventions for the treatment of unstable angina pectoris as an example,the effectiveness,safety,economy and affordability of the six interventions were systematically evaluated using the mesh meta-analysis,Markov decision tree model and BIA model.Methods:In this study,the literature research method was used to search the databases of CNKI,W.F.and VIP.According to the inclusion and exclusion criteria of the study,the randomized controlled clinical studies of six interventions for unstable angina pectoris were screened and the literature quality was evaluated.The efficacy and safety of the 6 interventions were evaluated by network meta analysis.Markov decision tree model was constructed to simulate disease outcome in 10years and evaluate the long-term economy of drugs.The budget impact analysis model was used to predict the possible impact of drugs on medical insurance fund after their inclusion in medical insurance,so as to evaluate the affordability of drugs.Contents:Network Meta analysis was used to evaluate the effectiveness and safety of six interventions for unstable angina pectoris,and Markov decision tree model was constructed to simulate disease outcome in 10years and evaluate the long-term economy of drugs based on cost data.The BIA model was used to predict the possible impact of drugs on medical insurance fund after their inclusion in medical insurance,so as to evaluate the affordability of drugs.Combined with the evaluation results of pharmacoeconomics,this paper puts forward some Suggestions for the selection of medical insurance catalogue of unstable angina pectoris.Results:The results of mesh meta analysis showed that,in terms of effectiveness,the order of clinical efficacy was from high to low:C+conventional treatment,D+conventional treatment,A+ conventional treatment,B+ conventional treatment,F+ conventional treatment,E+conventional treatment,and conventional treatment.The results of mesh meta-analysis showed that in terms of safety evaluation,the order of safety was from high to low:A+ conventional treatment,B+ conventional treatment,conventional treatment,C+ conventional treatment,F+ conventional treatment,D+conventional treatment,and E+conventional treatment.The results of economic analysis show that the order of incremental cost-effectiveness ratio is from low to high;C+ conventional treatment,D+ conventional treatment,B+conventional treatment,E+ conventional treatment,F+ conventional treatment.A+conventional treatment.The incremental cost-effectiveness ratio of the 6 interventions was all lower than the GDP per capita,and the cost increased by 1 QALY was totally worth it.The ICUR of C+ conventional treatment was the lowest,so C+ conventional treatment was the most cost-effective intervention.The result of BIA shows that when C is included in the medical insurance,the expenditure of medical insurance fund will increase,and the growth rate shows a decreasing trend year by year.Conclusion:In this study,network meta analysis,Markov model and budget impact analysis were used to evaluate six interventions for the treatment of unstable angina pectoris,and the effectiveness,safety,economy and affordability of drugs were systematically analyzed.Drugs were ranked according to the analysis results,providing references for the selection of the directory of insured drugs.Considering the limited quality of the original data in this study,higher quality studies should be included in the future to ensure the reliability of the results.