Wei-Bo Guo, Xi-Ju Guo, Meng-Yao Zheng, Xuan-Cheng Xie, Yong-Pin Wang, Bo Gan, Jin-Hui Yang
{"title":"急性-慢性肝衰竭治疗策略的成本-效果分析。","authors":"Wei-Bo Guo, Xi-Ju Guo, Meng-Yao Zheng, Xuan-Cheng Xie, Yong-Pin Wang, Bo Gan, Jin-Hui Yang","doi":"10.1016/j.transproceed.2025.08.026","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the cost-effectiveness of 3 artificial liver models, plasma exchange (PE), the double plasma molecular absorption system (DPMAS), and a combination of plasma exchange with the double plasma molecular absorption system (PE + DPMAS) as well as medical drugs in treating patients with acute-on-chronic liver failure.</p><p><strong>Methods: </strong>A retrospective approach was employed to collect clinical data from electronic medical records. The study included 296 patients who met the inclusion criteria and were categorized based on their treatment into 2 groups: the medical treatment group and the artificial liver group, the latter of which included PE, DPMAS, and PE + DPMAS. To compare the costs and effectiveness of the medical treatment group with the 3 artificial liver treatment groups, a pharmacoeconomic cost-effectiveness analysis was conducted to assess the economic aspects.</p><p><strong>Results: </strong>The effectiveness rate of the PE + DPMAS group was 76.9%, which was significantly higher than that of the PE and DPMAS group (P < .05). The effectiveness rate of the PE group was similar to that of the DPMAS group (P > .05). The effectiveness rate in all 3 artificial liver treatment groups was higher than that of the medical treatment group (P < .05). The total cost per person was RMB 54,661.6, RMB 61,385.5, RMB 71,789.2, and RMB 65,945.7 in the medical treatment, and the artificial liver PE group, DPMAS, and PE + DPMAS groups, respectively. The cost-effectiveness ratio (C/E) was 2009.6, 1162.6, 1511.4, and 758.9, respectively. The sensitivity analysis results for costs were consistent with the cost-effectiveness analysis results.</p><p><strong>Conclusions: </strong>The artificial liver treatment group demonstrated a superior \"performance-cost ratio,\" with the PE + DPMAS group being the most effective. This combination can be considered the optimal treatment for acute-on-chronic liver failure when combined with appropriate drug therapy.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Analysis of the Cost-Effectiveness of Treatment Strategies for Acute-on-Chronic Liver Failure.\",\"authors\":\"Wei-Bo Guo, Xi-Ju Guo, Meng-Yao Zheng, Xuan-Cheng Xie, Yong-Pin Wang, Bo Gan, Jin-Hui Yang\",\"doi\":\"10.1016/j.transproceed.2025.08.026\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to evaluate the cost-effectiveness of 3 artificial liver models, plasma exchange (PE), the double plasma molecular absorption system (DPMAS), and a combination of plasma exchange with the double plasma molecular absorption system (PE + DPMAS) as well as medical drugs in treating patients with acute-on-chronic liver failure.</p><p><strong>Methods: </strong>A retrospective approach was employed to collect clinical data from electronic medical records. The study included 296 patients who met the inclusion criteria and were categorized based on their treatment into 2 groups: the medical treatment group and the artificial liver group, the latter of which included PE, DPMAS, and PE + DPMAS. To compare the costs and effectiveness of the medical treatment group with the 3 artificial liver treatment groups, a pharmacoeconomic cost-effectiveness analysis was conducted to assess the economic aspects.</p><p><strong>Results: </strong>The effectiveness rate of the PE + DPMAS group was 76.9%, which was significantly higher than that of the PE and DPMAS group (P < .05). The effectiveness rate of the PE group was similar to that of the DPMAS group (P > .05). The effectiveness rate in all 3 artificial liver treatment groups was higher than that of the medical treatment group (P < .05). The total cost per person was RMB 54,661.6, RMB 61,385.5, RMB 71,789.2, and RMB 65,945.7 in the medical treatment, and the artificial liver PE group, DPMAS, and PE + DPMAS groups, respectively. The cost-effectiveness ratio (C/E) was 2009.6, 1162.6, 1511.4, and 758.9, respectively. The sensitivity analysis results for costs were consistent with the cost-effectiveness analysis results.</p><p><strong>Conclusions: </strong>The artificial liver treatment group demonstrated a superior \\\"performance-cost ratio,\\\" with the PE + DPMAS group being the most effective. This combination can be considered the optimal treatment for acute-on-chronic liver failure when combined with appropriate drug therapy.</p>\",\"PeriodicalId\":94258,\"journal\":{\"name\":\"Transplantation proceedings\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplantation proceedings\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.transproceed.2025.08.026\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation proceedings","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.transproceed.2025.08.026","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Analysis of the Cost-Effectiveness of Treatment Strategies for Acute-on-Chronic Liver Failure.
Objective: This study aimed to evaluate the cost-effectiveness of 3 artificial liver models, plasma exchange (PE), the double plasma molecular absorption system (DPMAS), and a combination of plasma exchange with the double plasma molecular absorption system (PE + DPMAS) as well as medical drugs in treating patients with acute-on-chronic liver failure.
Methods: A retrospective approach was employed to collect clinical data from electronic medical records. The study included 296 patients who met the inclusion criteria and were categorized based on their treatment into 2 groups: the medical treatment group and the artificial liver group, the latter of which included PE, DPMAS, and PE + DPMAS. To compare the costs and effectiveness of the medical treatment group with the 3 artificial liver treatment groups, a pharmacoeconomic cost-effectiveness analysis was conducted to assess the economic aspects.
Results: The effectiveness rate of the PE + DPMAS group was 76.9%, which was significantly higher than that of the PE and DPMAS group (P < .05). The effectiveness rate of the PE group was similar to that of the DPMAS group (P > .05). The effectiveness rate in all 3 artificial liver treatment groups was higher than that of the medical treatment group (P < .05). The total cost per person was RMB 54,661.6, RMB 61,385.5, RMB 71,789.2, and RMB 65,945.7 in the medical treatment, and the artificial liver PE group, DPMAS, and PE + DPMAS groups, respectively. The cost-effectiveness ratio (C/E) was 2009.6, 1162.6, 1511.4, and 758.9, respectively. The sensitivity analysis results for costs were consistent with the cost-effectiveness analysis results.
Conclusions: The artificial liver treatment group demonstrated a superior "performance-cost ratio," with the PE + DPMAS group being the most effective. This combination can be considered the optimal treatment for acute-on-chronic liver failure when combined with appropriate drug therapy.
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