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ORIGINAL RESEARCH

Cost-Effectiveness Analysis of the TCM “Yupingfeng Granules” in the Treatment of Acute Exacerbations of COPD Based on a Randomized Clinical Trial

ORCID Icon, , , , ORCID Icon &
Pages 2369-2379 | Received 31 May 2022, Accepted 10 Sep 2022, Published online: 23 Sep 2022

Figures & data

Figure 1 Markov bubble chart of Yupingfeng granules in the treatment of chronic obstructive pulmonary disease. We set the following assumptions for the model: a. The nonsevere exacerbation stage was a relatively stable period during the longer disease course of COPD. Therefore, the mortality rate in the nonsevere exacerbation period was assumed to be the natural mortality rate of the Chinese population. b. Referring to relevant literature at home and abroad, it is shown that most patients in the nonsevere exacerbation stage will return to the stable stage after treatment. Therefore, the model sets the transfer branch from the nonsevere exacerbation stage to the stable stage. In addition, most treatments will make patients in the nonsevere exacerbation stage return to the stable stage. We assumed that the transition probabilities from the nonsevere exacerbation phase to the stable phase were the same between the two treatment regimens in this study. c. Since severe exacerbation was defined as the need for hospitalization, it is assumed that returning from the severe exacerbation period to the stable period was difficult, and only the path from the severe exacerbation period to the current state or death was set. d. It was assumed that in one year, each state generated two medical service fees and examination fees. An additional outpatient treatment fee was required in the nonsevere exacerbation period, and an additional inpatient fee was required in the severe exacerbation period.

Figure 1 Markov bubble chart of Yupingfeng granules in the treatment of chronic obstructive pulmonary disease. We set the following assumptions for the model: a. The nonsevere exacerbation stage was a relatively stable period during the longer disease course of COPD. Therefore, the mortality rate in the nonsevere exacerbation period was assumed to be the natural mortality rate of the Chinese population. b. Referring to relevant literature at home and abroad, it is shown that most patients in the nonsevere exacerbation stage will return to the stable stage after treatment. Therefore, the model sets the transfer branch from the nonsevere exacerbation stage to the stable stage. In addition, most treatments will make patients in the nonsevere exacerbation stage return to the stable stage. We assumed that the transition probabilities from the nonsevere exacerbation phase to the stable phase were the same between the two treatment regimens in this study. c. Since severe exacerbation was defined as the need for hospitalization, it is assumed that returning from the severe exacerbation period to the stable period was difficult, and only the path from the severe exacerbation period to the current state or death was set. d. It was assumed that in one year, each state generated two medical service fees and examination fees. An additional outpatient treatment fee was required in the nonsevere exacerbation period, and an additional inpatient fee was required in the severe exacerbation period.

Table 1 Markov Model Cost Parameters and Sources

Table 2 Markov Transition Probability Parameters and Sources

Table 3 Utility Parameters and Sources

Table 4 Cost-Effectiveness of Yupingfeng Group Compared with Placebo Group

Figure 2 One-way sensitivity analysis tornado diagram.

Notes: The influencing factors from highest to lowest are: a:C_YU, the medicine cost of Yupingfeng group; b: C_CONTROL, the cost of conventional treatment medicine; c: p5_A, the transition probability of the stable phase-severe exacerbation state in the Yupingfeng group; d: p2_B, the transition probability of the stable phase-stable phase in the placebo group; e: C_in, the average hospitalization expenses every time; f: p4_B, Stable phase-nonsevere exacerbation transition probability of the placebo group; g: udiscount, discount rate; h: p12, Severe exacerbation-death transition probability; i: p9, Nonsevere exacerbation-severe exacerbation transition probability; j: p1_A, Stable phase-stable phase transition probability of the Yupingfeng Group; k: p7, Stable phase-death transition probability; l: U_stable, Stable phase utility value; m:U_serious, Severe exacerbation utility value; n: U_noserious, Nonsevere exacerbation utility value; o:C_out, Average cost of outpatient visits/time; p: p10, Nonsevere exacerbation-death transition probability; q: C_View, the cost of general practitioner treatment; r: C_sp, the cost of laboratory inspection costs; s: p8, Nonsevere exacerbation-stable phase transition probability; t: p6_B, Stable phase-severe exacerbation transition probability of the placebo group; u: p3_A, Stable phase-nonsevere exacerbation transition probability of the Yupingfeng Group; v: p11, Severe exacerbation-severe exacerbation transition probability.
Figure 2 One-way sensitivity analysis tornado diagram.

Figure 3 Monte Carlo simulation pseudoscatter plot.

Figure 3 Monte Carlo simulation pseudoscatter plot.

Figure 4 Cost-effectiveness acceptable curve plotting.

Figure 4 Cost-effectiveness acceptable curve plotting.