目的 比較芪骨膠囊與仙靈骨葆膠囊治療原發(fā)性骨質(zhì)疏松癥的經(jīng)濟(jì)性，為臨床決策提供參考與建議。方法 從全社會(huì)角度出發(fā)，通過建立決策樹模型對(duì)芪骨膠囊與仙靈骨葆膠囊治療方案進(jìn)行成本效果分析，并針對(duì)參數(shù)的不確定性進(jìn)行敏感性分析。結(jié)果 芪骨膠囊治療骨質(zhì)疏松癥的總成本為1 998.93元人民幣，仙靈骨葆膠囊方案的總成本為1 428.44元；芪骨膠囊方案的有效率為99.72%，仙靈骨葆膠囊方案的有效率為98.32%；與仙靈骨葆膠囊相比，芪骨膠囊治療骨質(zhì)疏松癥的增量成本效果比為40 779.00，即每多避免1例骨折發(fā)生，多花費(fèi)的成本為40 779.00元。單因素敏感性分析結(jié)果與基礎(chǔ)分析結(jié)果一致。概率敏感性分析結(jié)果顯示，當(dāng)意愿支付值小于60 000元人民幣時(shí)，仙靈骨葆膠囊為較優(yōu)方案，當(dāng)意愿支付值達(dá)到60 000元時(shí)，芪骨膠囊更具有顯著的成本效果優(yōu)勢(shì)。結(jié)論 綜合考慮骨折后治療費(fèi)用及患者生存質(zhì)量的降低，兩方案皆可被作為臨床推薦用藥，患者可根據(jù)自身的經(jīng)濟(jì)條件選擇適合的治療方案。

Objective The objective of this study was to evaluate and compare the cost effectiveness of Qigu Capsules and Xianlinggubao Capsules for Chinese primary osteoporosis patients, and to provide some advice to clinicians. Methods A decision tree model was used to perform the cost-effectiveness analysis of Qigu Capsules and Xianlinggubao Capsules from the societal perspective. The uncertainty of parameters was estimated by sensitivity analysis. Results The total cost for Qigu Capsules group was ￥1 998.93, while the total cost for Xianlinggubao Capsules was ￥1 428.44. The effective rate of Qigu Capsules group was 99.72%, and the effective rate of Xianlinggubao was 98.32%. The ICER was 40 779.00 which means Qigu Capsules group cost more ￥40 779.00 to avoid one case of fractures. Result of one-way sensitivity analysis was the same with fundamental analysis. Probabilistic sensitivity analyses indicated that when the threshold value of willingness to pay (WTP) is less than ￥60 000, Xianlinggubao Capsules is the most cost-effective, and when the threshold value is over ￥60 000, Qigu Capsules has significant cost-effective advantage. Conclusions Considering the current economic burden of fractures in China and the reduction of the quality of life of patients, both treatments are recommended for clinical use, and patients should choose the most appropriate treatments according to their WTP.