Traditional Chinese medicine in treating Corona Virus Disease 2019: a systematic review and cost-effectiveness analysis

T. Shao, Ke Wang, Xing Liao, Wenxi Tang
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Abstract

ABSTRACT Background: Currently, corona virus disease 2019 (COVID-19) has infected 633,601,048 people worldwide according to World Health Organization, which leads to huge disease burden. A considerable number of trials of traditional Chinese medicine (TCM) have been carried out and have shown the efficacy of TCM in the treatment of COVID-19, but their cost-effectiveness has not been studied, especially in China. Therefore, we plan to perform a systematic review and cost-effectiveness analysis to explore the cost-effectiveness of using TCM in treating COVID-19. Methods: A systematic review based on previously published secondary data from randomized controlled trials and observational studies which included TCM as one of the interventions for patients with COVID-19 will be performed. Patients with COVID-19 will be classified into five specific groups (patients without diagnosis; patients with mild, moderate, severe and critical symptoms). TCM versus western medicine on both effectiveness outcomes(cure rate and survival rate) and utility outcome(quality-adjusted life years) will be evaluated. A decision tree model will be established taking the perspective of Chinese health care system since the costs were paid by the Chinese government. Cumulative costs, Qalys, and incremental cost-effectiveness ratio will be selected as the outcome indicator. Sensitivity analysis will also be conducted to evaluate the impact of parameter uncertainty on the base-case analyses results. We will present results at various willingness-to-pay thresholds using a cost-effectiveness acceptability curve. Discussion We hope to demonstrate the cost-effectiveness of TCM, see an improvement in the patients' quality of life, achieve a improvement in the cure rate and survival rate of COVID-19. If TCM is cost-effectiveness, it could be applied to clinical practice decision making. Ethics and dissemination: Ethics approval is not required for the current study. Because the data used in this study is just the re-use of data which are already in the public domain. The results will be disseminated to general public, clinicians, academics and policy makers. Registration number: CRD42021228887 Keywords: Traditional Chinese medicine; Corona Virus Disease 2019; decision tree model; systematic review; cost-effectiveness analysis
2019年中医药治疗冠状病毒病:系统评价和成本效益分析
背景:据世界卫生组织统计,目前全球冠状病毒病2019 (COVID-19)感染人数已达633,601,048人,疾病负担巨大。大量的中医药试验已经开展,并显示了中医药治疗新冠肺炎的疗效,但其成本效益尚未得到研究,特别是在中国。因此,我们计划进行系统评价和成本-效果分析,探讨中医药治疗COVID-19的成本-效果。方法:基于先前发表的随机对照试验和观察性研究的二手数据进行系统评价,这些研究将中医药作为COVID-19患者的干预措施之一。COVID-19患者将被分为五个特定组(未确诊患者;轻度、中度、重度、危重症状患者)。将评估中医与西药的疗效结果(治愈率和生存率)和效用结果(质量调整生命年)。由于成本由中国政府支付,因此将从中国医疗保健系统的角度建立决策树模型。将选择累积成本、质量指标和增量成本效益比作为结果指标。还将进行敏感性分析,以评估参数不确定性对基本情况分析结果的影响。我们将使用成本效益可接受性曲线呈现不同支付意愿阈值的结果。我们希望展示中医的成本效益,改善患者的生活质量,提高COVID-19的治愈率和生存率。如果中医具有成本效益,则可以应用于临床实践决策。伦理与传播:本研究不需要伦理批准。因为本研究中使用的数据只是对已经在公共领域的数据的再利用。研究结果将向公众、临床医生、学者和决策者传播。注册号:CRD42021228887关键词:中药;2019冠状病毒病;决策树模型;系统评价;成本效益分析
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