广东省社区美沙酮维持治疗的评价与决策分析

目的通过Markov模型进行MonteCarlo模拟,对广东省社区美沙酮维持治疗进行评价与决策分析。方法建立Markov决策模型,应用MonteCarlo模拟进行成本效用分析。结果平均每个吸毒者30年中不维持治疗与维持治疗的费用分别为114.4(101.2～129.6)万元与81.9(62.4～102.3)万元,效用值分别为9.7(8.9～10.7)QALY与12.3(10.4～14.2)QALY,C/E分别为11.8(10.3～13.0)万元/QALY与6.7(4.5～9.6)万元/QALY,ICUR为-12.5万元/QALY。结论MonteCarlo试验模拟能估计成本与效用的变异,并能进行统计学检验,对于结果的预测有积极意义。

Evaluation and Decision Analysis of Methadone Maintenance Treatmentin Guangdong Province

Objective Developing Monte Carlo simulation by using a Markov model,to analysis the cost-effectiveness of Methadone Maintenance Treatment in Guangdong Province community.Methods Establishing a Markov decision-making model,and using Monte Carlo simulation to analysis the cost-effectiveness.Results On average the expense of each drug user not in methadone treatment (CT group) is 1144 thousand RMB.The 95% CI is 1012 thousand RMB to 1296 thousand RMB.The utility is 9.7 QALY,and 95% CI is 8.9 to 10.7 QALY.Cost-Utility ratio (CE ratio) is 118 thousand RMB per QALY,and 95% CI is 103 to 130 thousand RMB per QALY.In Methadone maintenance treatment group (MMT group),the cost is 819 thousand RMB,and 95% CI is 624 to 1023 thousand RMB.The utility is 12.3 QALY,and 95% CI is 10.4 to 14.2 QALY.CE ratio is 67 thousand RMB per QALY,95% CI is 45 to 96 thousand RMB per QALY.The increment cost-utility ratio (ICUR) is -125 thousand RMB per QALY.Conclusion Monte Carlo trial simulation can estimate the deviation of cost and utility,and carry on the statistics test.It has the active effect on the result prediction.