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Abstract：
BACKGROUND: Oral aripiprazole exhibits favorable clinical efficacy and safety in the suppression of tics in children and adolescents with tic disorders. This study aims to evaluate and compare the cost-effectiveness of high-dose and low-dose aripiprazole in children and adolescents with tic disorders from the perspective of the Chinese healthcare system.
METHODS: A questionnaire survey was conducted on 146 patients with tic disorders, of whom 144 completed EQ-5D-Y and YGTSS. Four models were built to convert YGTSS onto EQ-5D-Y utility using two mapping algorithms. We constructed a decision tree model containing efficacy and safety to compare the cost-effectiveness of high-dose and low-dose aripiprazole based on our mapping function.
RESULTS: The GLM with model 1 (YGTSS total tic scores) was selected as the preferred function in our decision tree model. The base case cost-effectiveness analysis showed that compared to low-dose aripiprazole, high-dose aripiprazole improves effectiveness by 0.001QALYs and increases the overall cost by $197.99, resulting in an ICER of $174339.22 per QALY, which exceeds three times the gross domestic product per capita. Hence, high-dose aripiprazole is not likely to be a cost-effective option for child patients with tic disorders. One-way sensitivity analysis and probabilistic sensitivity analysis showed that these results is robust.
CONCLUSIONS: On the basis of currently available data, low-dose aripiprazole may be a safe, effective, and economical dosage for children and adolescents with tic disorders.
CONCLUSIONS: The main limitation of our study is the lack of utility directly used for cost-effectiveness analysis. We obtained the utility of patients with tic disorders indirectly by the mapping function. This may introduce some bias and uncertainty. And it is a limitation to use the direct medical costs of Germany in our model. Although we converted it to the equivalent value of China using purchasing power parities, caution should be exercised when interpreting the results of this study.
METHODS: A questionnaire survey was conducted on 146 patients with tic disorders, of whom 144 completed EQ-5D-Y and YGTSS. Four models were built to convert YGTSS onto EQ-5D-Y utility using two mapping algorithms. We constructed a decision tree model containing efficacy and safety to compare the cost-effectiveness of high-dose and low-dose aripiprazole based on our mapping function.
RESULTS: The GLM with model 1 (YGTSS total tic scores) was selected as the preferred function in our decision tree model. The base case cost-effectiveness analysis showed that compared to low-dose aripiprazole, high-dose aripiprazole improves effectiveness by 0.001QALYs and increases the overall cost by $197.99, resulting in an ICER of $174339.22 per QALY, which exceeds three times the gross domestic product per capita. Hence, high-dose aripiprazole is not likely to be a cost-effective option for child patients with tic disorders. One-way sensitivity analysis and probabilistic sensitivity analysis showed that these results is robust.
CONCLUSIONS: On the basis of currently available data, low-dose aripiprazole may be a safe, effective, and economical dosage for children and adolescents with tic disorders.
CONCLUSIONS: The main limitation of our study is the lack of utility directly used for cost-effectiveness analysis. We obtained the utility of patients with tic disorders indirectly by the mapping function. This may introduce some bias and uncertainty. And it is a limitation to use the direct medical costs of Germany in our model. Although we converted it to the equivalent value of China using purchasing power parities, caution should be exercised when interpreting the results of this study.
摘要：
背景：口服阿立哌唑在抑制患有抽动障碍的儿童和青少年抽动方面具有良好的临床疗效和安全性。本研究旨在从中国医疗系统的角度评估和比较高剂量和低剂量阿立哌唑在儿童和青少年抽动障碍中的成本效益。
方法:对146例抽动障碍患者进行问卷调查,其中144人完成了EQ-5D-Y和YGTSS。使用两种映射算法，建立了四个模型将YGTSS转换为EQ-5D-Y实用程序。我们构建了包含疗效和安全性的决策树模型，以根据我们的映射函数比较高剂量和低剂量阿立哌唑的成本效益。
结果：在我们的决策树模型中选择了具有模型1（YGTSS总评分）的GLM作为首选函数。基本病例成本-效果分析表明,与低剂量阿立哌唑相比,大剂量阿立哌唑可提高0.001QALYs的有效性，并增加197.99美元的总成本，导致每QALY的ICER为174339.22美元，超过人均国内生产总值的三倍。因此，对于患有抽动障碍的儿童患者,大剂量阿立哌唑不太可能是一种具有成本效益的选择.单因素敏感性分析和概率敏感性分析表明，这些结果是稳健的。
结论：根据现有数据，低剂量阿立哌唑可能是安全的，有效,和儿童和青少年抽动障碍的经济剂量。
结论：我们研究的主要局限性是缺乏直接用于成本效益分析的效用。我们通过映射函数间接获得了抽动障碍患者的效用。这可能会引入一些偏见和不确定性。在我们的模型中使用德国的直接医疗费用是一个限制。尽管我们使用购买力平价将其转换为中国的等值，在解释本研究结果时应谨慎行事。
方法:对146例抽动障碍患者进行问卷调查,其中144人完成了EQ-5D-Y和YGTSS。使用两种映射算法，建立了四个模型将YGTSS转换为EQ-5D-Y实用程序。我们构建了包含疗效和安全性的决策树模型，以根据我们的映射函数比较高剂量和低剂量阿立哌唑的成本效益。
结果：在我们的决策树模型中选择了具有模型1（YGTSS总评分）的GLM作为首选函数。基本病例成本-效果分析表明,与低剂量阿立哌唑相比,大剂量阿立哌唑可提高0.001QALYs的有效性，并增加197.99美元的总成本，导致每QALY的ICER为174339.22美元，超过人均国内生产总值的三倍。因此，对于患有抽动障碍的儿童患者,大剂量阿立哌唑不太可能是一种具有成本效益的选择.单因素敏感性分析和概率敏感性分析表明，这些结果是稳健的。
结论：根据现有数据，低剂量阿立哌唑可能是安全的，有效,和儿童和青少年抽动障碍的经济剂量。
结论：我们研究的主要局限性是缺乏直接用于成本效益分析的效用。我们通过映射函数间接获得了抽动障碍患者的效用。这可能会引入一些偏见和不确定性。在我们的模型中使用德国的直接医疗费用是一个限制。尽管我们使用购买力平价将其转换为中国的等值，在解释本研究结果时应谨慎行事。
