Objective  To evaluate economics of Bailing capsules combined with western medicine conventional treatment compared with western medicine conventional treatment in diabetic kidney disease.

Methods  Meta-analysis was performed to investigate clinical efficacy and safety of Bailing capsules combined with western medicine conventional treatment (Bailing capsules group) compared with western medicine conventional treatment (control group) in diabetic kidney disease. From the perspective of health system in China, cost-effectiveness analysis was conducted by establishing a decision tree model. After the efficacy and safety results were obtained by meta-analysis, the short-term economics of the two treatment regimens were comprehensively evaluated. The efficacy index was the total effective rate and the time horizon was 3 months. One-way sensitivity analysis, probabilistic sensitivity analysis and scenario analysis were used to evaluate the robustness of the results.

Results  A total of 34 RCTs involving 3 114 patients were included in meta-analysis. The results of meta- analysis showed that when the treatment time was 3 months, the total effective rate of Bailing capsules group was higher than that of control group (RR=1.32, 95%CI 1.25 to 1.39, P﹤0.001), while its safety was similar to control group. Cost-effectiveness analysis showed that compared with the conventional western medicine treatment alone, the ICER value of Bailing capsule combined with western medicine conventional treatment was 5 223 yuan, and sensitivity analysis showed that the dosage of Bailing capsules and the total effective rate of the two therapies had great influence on the results. When the willingness-to-pay value was higher than 5 150 yuan, the probability of Bailing capsules combined with western medicine conventional treatment was more economical than 50%.

Conclusion  When time horizon was 3 months, compared with western medicine conventional treatment, Bailing capsules combined with western medicine conventional treatment is more economical for patients with diabetic kidney disease who are willing to pay more than 5 150 yuan.

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