Cost minimization analysis of Danmu extract syrup and Xiaoer Chiqiao Qingre granules for acute upper respiratory tract infection in children_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Dan ^1,2 , LI Hailong ^1,2 , ZENG Linan ^1,2 , YI Qiusha ^1,2 ,  WU Bin ³ ,  ZHANG Lingli ^1,2,4

1. Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, P. R. China;
3. Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200001, P. R. China;
4. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WU Bin, Email: withtop@126.com; ZHANG Lingli, Email: zhanglingli@scu.edu.cn

Keywords：

Acute upper respiratory tract infection; Cohort study; Danmu extract syrup; Health economy; Cost minimization analysis

DOI：

10.7507/1672-2531.202202055

Video：

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Objective To compare the costs of Danmu extract syrup and Xiaoer Chiqiao Qingre granules for the treatment of acute upper respiratory tract infection (AURI) in children. Methods We conducted this prospective cohort study from July 2018 to June 2020. Children with AURI in the pediatric outpatient department and emergency department of West China Second Hospital were enrolled, and were divided into two groups: Danmu extract syrup group (Danmu group) and Xiaoer Chiqiao Qingre granule group (Chiqiao group) according to the treatment. The pharmacoeconomic evaluation took the medical and health system as the research perspective and considered direct medical costs, including registration fees, drug fees, inspection fees, testing fees, and treatment fees. A cost-effectiveness analysis or a cost minimization analysis was adopted according to the results of efficacy between the two groups. Results We enrolled 1 036 children with AURI. After propensity score matching, 252 in the Danmu group and 253 in the Chiqiao group were included. There was no statistically significant difference in the symptom recovery time between the two groups. The cost minimization analysis showed that the total costs (median difference −21.55) and drug costs (median difference −7.24) of the Danmu group were significantly lower than those of the Chiqiao group (P<0.001). The results of the subgroup and sensitivity analyses were consistent with the primary analysis. Conclusion Danmu extract syrup is a cost-saving alternative compared with Chiqiao granules for AURI in children.

Citation： LIU Dan, LI Hailong, ZENG Linan, YI Qiusha, WU Bin, ZHANG Lingli. Cost minimization analysis of Danmu extract syrup and Xiaoer Chiqiao Qingre granules for acute upper respiratory tract infection in children. Chinese Journal of Evidence-Based Medicine, 2022, 22(9): 1007-1011. doi: 10.7507/1672-2531.202202055 Copy

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1. Heikkinen T, Järvinen A. The common cold. Lancet, 2003, 361(9351): 51-59.
2. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 2017, 390(10100): 1211-1259.
3. Pappas DE, Hendley JO. The common cold and decongestant therapy. Pediatr Rev, 2011, 32(2): 47-54.
4. Hersh AL, Jackson MA, Hicks LA, et al. Principles of judicious antibiotic prescribing for upper respiratory tract infections in pediatrics. Pediatrics, 2013, 132(6): 1146-1154.
5. UpToDate. The common cold in children: management and prevention. Available at: www. uptodate. com/contents/the-common-cold-in-children-management-and-prevention.
6. Marom T, Alvarez-Fernandez PE, Jennings K, et al. Acute bacterial sinusitis complicating viral upper respiratory tract infection in young children. Pediatr Infect Dis J, 2014, 33(8): 803-808.
7. Lopardo G, Calmaggi A, Clara L, et al. Consensus guidelines for the management of upper respiratory tract infections. Medicina, 2012, 72(6): 484-494.
8. 戎萍, 马融, 刘全慧, 等. 中成药治疗小儿急性上呼吸道感染研究述评. 中国中药杂志, 2017, 42(8): 1455-1466.
9. Wang WY, Zhou H, Wang YF, et al. Current policies and measures on the development of traditional Chinese medicine in China. Pharmacol Res, 2021, 163: 105187.
10. Wang C, Cao B, Liu QQ, et al. Oseltamivir compared with the Chinese traditional therapy maxingshigan-yinqiaosan in the treatment of H1N1 influenza: a randomized trial. Ann Intern Med, 2011, 155(4): 217-225.
11. Shi N, Liu B, Liang N, et al. Association between early treatment with Qingfei Paidu decoction and favorable clinical outcomes in patients with COVID-19: a retrospective multicenter cohort study. Pharmacol Res, 2020, 161: 105290.
12. 方邦江, 崔应麟, 李志军, 等. 急性上呼吸道感染中成药应用专家共识. 中国中西医结合急救杂志, 2019, (2): 129-138.
13. 廖凯. 胆木浸膏糖浆治疗小儿病毒性感冒临床效果及安全性分析. 中外医学研究, 2017, 15(1): 18-19.
14. 刘伟, 李含英, 张秋月, 等. 小儿感冒发热患者采用胆木浸膏糖浆治疗疗效观察. 中国社区医师, 2016, 32(27): 100,102.
15. 陈路佳, 唐榕, 刘立立, 等. 小儿豉翘清热颗粒治疗小儿上呼吸道感染的系统评价. 中国药业, 2013, 22(14): 47-50.
16. 袁丹, 谢辉辉, 汪受传, 等. 小儿豉翘清热颗粒治疗急性上呼吸道感染临床疗效的Meta分析. 中华中医药杂志, 2016, 31(1): 89-92.
17. 王卫平, 孙锟, 常立文, 等. 儿科学(第9版). 北京: 人民卫生出版社, 2018.
18. 中华中医药学会儿科分会临床评价学组. 小儿急性上呼吸道感染中药新药临床试验设计与评价技术指南. 药物评价研究, 2015, 38(1): 8-16.
19. 国家药品不良反应监测中心. 药品不良反应报告和监测工作手册(2012). Available at: http://www.cdr-adr.org.cn/drug_1/zcfg_1/zcfg_zdyz/202009/t20200924_47831.html.
20. 国家药品监督管理局, 国家卫生健康委员会. 药物临床试验质量管理规范(2020). Available at: http://www.nhc.gov.cn/yzygj/s7659/202004/1d5d7ea301f04adba4c4e47d2e92eb96.shtml.
21. 中国药学会. 中国药物经济学评价指南2020. Available at: https://www.cpa.org.cn/cpadmn/attached/file/20201203/1606977380634185.pdf.
22. 张俊华, 孙鑫, 李幼平, 等. 循证中医药学的现在和未来. 中国循证医学杂志, 2019, 19(5): 515-520.
23. 张俊华, 李幼平, 张伯礼, 等. 循证中医药研究: 北京宣言. 中国循证医学杂志, 2020, 20(8): 869-870.
24. 李晓菊, 毕雪艳, 姜艳. 2种中药注射液治疗小儿急性上呼吸道感染的疗效观察与成本-效果分析. 中国药业, 2011, 20(1): 64-65.
25. Zeng L, Li H, Zhang C, et al. Effectiveness and safety of Danmu extract syrup for acute upper respiratory tract infection in children: a real-world, prospective cohort study. J Evid Based Med, 2022, 15(1): 19-29.

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Cost minimization analysis of Danmu extract syrup and Xiaoer Chiqiao Qingre granules for acute upper respiratory tract infection in children

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