ObjectiveRenal denervation (RDN) therapy is an innovative interventional therapy for patients with refractory hypertension and antihypertensive drug intolerance. In China, four RDN products were approved by National Medical Products Administration. This study aims to construct a comprehensive value assessment framework for RDN therapy to support the rational selection and application in Chinese hospitals.MethodsMultiple Criteria Decision Analysis (MCDA) approach was used to develop the framework. We conducted a literature review and focus group interviews to identify the list of criteria that should be included in the framework. Then, the Delphi method was applied to refine the framework. With the engagement of cardiologists and non-clinical professionals from hospitals in different regions, weights were given to each criterion by the Analytic Hierarchy Process.ResultsThe comprehensive value assessment framework for RDN therapy consists of three levels of criteria in seven domains, including seven criteria at the first level, 16 secondary criteria and 30 sub-criteria at the third level. The distribution of criteria weights at the first level is: efficacy (23.26%), safety (21.83%), qualification and suitability (16.84%), patient value (15.18%), innovation (10.65%), management value (6.22%), and cost (6.01%). The prioritized domains are efficacy, safety, qualification and suitability.ConclusionThe development of a comprehensive value assessment framework for RDN can serve as a reliable and scientific tool to support the procurement reviews and decisions for RDN devices in Chinese hospitals.

BACKGROUND Biologics are the preferred treatment for patients with moderate to severe Crohn’s disease (CD). Four biologics included in China’s National Reimbursement Drug List are available for CD treatment. Due to loss of response, patients need switching to another biologic, making it necessary to evaluate the cost-effectiveness of different biologic treatment sequences. AIM To assess the cost-effectiveness of sequential treatment strategies with National Reimbursement Drug List-included biologics for moderate to severe CD in China. METHODS From a healthcare system perspective, a Markov model was constructed to evaluate the cost-effectiveness of four biologics [infliximab, adalimumab (ADA), ustekinumab (UST), and vedolizumab] applied in different treatment sequences for moderate to severe CD patients. Using one times the GDP per capita ($13444.68, 2024) in China as the willingness-to-pay threshold, the absolute net monetary benefit (NMB) and incremental cost-effectiveness ratio (ICER) were calculated. Both costs and utilities were discounted at an annual rate of 5%. Sensitivity analyses were conducted on key parameters. RESULTS With $13444.68 as willingness-to-pay, among the 17 treatment sequences evaluated for biologic-naïve patients, sequence 3 (ADA-UST) yielded the highest absolute NMB of $35850.93. Compared with sequence 1 (vedolizumab-UST), sequence 3 had the most favorable ICER of $2285.38/quality-adjusted life year. For biologic-exposed patients, sequence 3 still demonstrated the optimal NMB and ICER results. CONCLUSION Adding biologic treatment lines provides greater health benefits for patients with moderate to severe CD. Among the various sequential strategies, the treatment sequence combining ADA and UST is more likely to be the optimal cost-effective option in China.

Background: Pulmonary air leak (PAL) is one of the most frequent complications following lung resection. While its short-term clinical and economic impacts are well documented, the long-term economic value of interventions that reduce PAL duration remains poorly quantified. This study developed a novel methodological framework to estimate the long-term economic value of PAL reduction and to provide a rapid, quantitative approach for assessing the cost-effectiveness of related clinical interventions. Methods: We developed a hybrid decision-tree-Markov model simulating the natural history and health state transitions following pulmonary resection. Marginal analysis was applied to quantify the relationship between PAL duration (in days) and long-term costs (from both societal and healthcare system perspectives) as well as health outcomes measured in quality-adjusted life years (QALYs). Deterministic sensitivity analyses were performed on key model parameters to assess robustness. Results: Each additional day of PAL was associated with an increase in long-term societal costs of USD 390.4, healthcare system costs of USD 348.1, and a loss of 0.0087 QALYs. Using a willingness-to-pay (WTP) threshold equivalent to one times China's 2024 per capita GDP (USD 13,447.9), the monetized value of the QALY loss amounted to USD 117.6. Consequently, each 1-day reduction in PAL duration generated a total long-term economic benefit of USD 508.0 from a societal perspective and USD 465.7 from a healthcare system perspective. Sensitivity analyses confirmed the stability of these estimates across plausible parameter ranges. Conclusions: This study provides the first quantitative estimation of the long-term economic value of reducing PAL duration after lung resection. The derived marginal values offer a practical, evidence-based tool for rapidly evaluating the economic rationale of PAL-targeted interventions and can inform clinical decision-making, health technology assessment, and policy development in thoracic surgery.

Objective:Telitacicept and belimumab are the only two approved biologics in China for treating systemic lupus erythematosus (SLE). With the widespread clinical use of biologics, more reliable clinical evidence has been provided. This study seeks to evaluate the cost-effectiveness of two biologic treatments for SLE in China by utilizing current medication prices and the most recent clinical research. Methods:A cost-effectiveness analysis comparing telitacicept and belimumab was conducted by developing a lifetime SLE partition survival model using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) score, which considers the relationship between organ damage and death. The data were extracted from the literature with model assumptions. Scenario analysis of short term treatment (5 years) and typical one-way and probabilistic sensitivity analyses were performed. Results:After lifetime simulation, compared to belimumab treatment, telitacicept treatment can save a total of ¥57751.00, including expenses of drug usage and treatment of complications. Meanwhile, it gained 0.499 quality adjusted life years, resulted in a negative ICER. Telitacicept is more cost-saving than belimumab (Dominant). Conclusion:Under current pricing, treatment settings and efficacy data in China, telitacicept demonstrates superior cost-effectiveness compared with belimumab for long-term SLE management by reducing medication costs while delivering additional health benefits.

Lung cancer is the leading cause of cancer-related deaths in China, and pembrolizumab shows differential efficacy in advanced non-small cell lung cancer (NSCLC) with different PD-L1 expression levels. To assess the cost-effectiveness of PD-L1 testing associated with pembrolizumab for first-line treatment of NSCLC from the perspective of Chinese healthcare system. Over a lifetime horizon, a three-state partitioned survival model was developed to assess the cost-effectiveness of PD-L1 testing and no PD-L1 testing. In the PD-L1 testing group, patients were stratified by PD-L1 tumor proportion score ≥ 50

BackgroundDiabetes structured education programs have been demonstrated to effectively improve glycemic control and self-management behaviors. However, evidence on the health economic evaluation of these programs is limited.ObjectivesTo systematically review the health economic evaluation of structured education programs for patients with type 1 and type 2 diabetes mellitus.MethodsThe English databases PUBMED, WEB OF SCIENCE, OVID, COCHRANE LIBRARY, EMBASE, and EBSCO, along with the Chinese databases CNKI, WANFANG, VIP, and SINOMED, were searched from their inception to September 2024. The quality of the literature was assessed using the CHEERS 2022 checklist. A descriptive analysis was performed on the studies included in the review, with all currencies converted to international dollars. An incremental cost-effectiveness ratio of less than one times the per capita GDP was considered highly cost-effective, while a ratio between one and three times the per capita GDP was considered cost-effective.ResultsA total of 28 studies from upper-middle-income and high-income countries were included. The average quality score of the included studies was 18.6, indicating a moderate level of reporting quality. Among these, eleven studies demonstrated that diabetes structured education programs were highly cost-effective and twelve were found to be cost-effective. In contrast, three studies were deemed not cost-effective, and two studies provided uncertain results. The ranges of the incremental cost-effectiveness ratios for short-term, medium-term, and long-term studies were − 520.60 to 65,167.00 dollars, −24,952.22 to 14,465.00 dollars, and −874.00 to 236,991.67 dollars, respectively.ConclusionThis study confirms the cost-effectiveness of structured education programs for diabetes and highlights their importance for patients with type 2 diabetes who have HbA1c levels exceeding 7% and are receiving non-insulin therapy. Additionally, the potential advantages of incorporating telecommunication technologies into structured diabetes education were emphasized. These findings offer valuable insights and guidance for decision-making in diabetes management and clinical practice, contributing to the optimization of medical resource allocation and the improvement of health status and quality of life for patients.

Objective: To evaluate the cost-effectiveness of mirogabalin in treatment of Chinese patients with DPNP or PHN, and to discuss its reasonable pricing strategy. Methods: A cost-effectiveness analysis was performed by constructing a three-state Markov model (mild, moderate, and severe pain) to compare mirogabalin with placebo and pregabalin for DPNP or PHN patients from Chinese healthcare system perspective. The efficacy parameters were derived from randomized clinical trials (RCTs) comparing mirogabalin with placebo in the treatment of PHN or DPNP, as well as from network meta-analyses comparing mirogabalin/pregabalin with placebo RCTs. The health utility values were obtained from published literatures. Cost parameters contained cost of pregabalin, supportive care, and other medical resource utilization, were sourced from both published literature and public price database. Sensitivity analysis was conducted on key parameters to verify the stability of the results. Results: With one-year time horizon, for PHN, the incremental quality-adjusted life years (ΔQALYs) of mirogabalin compared with placebo and pregabalin were 0.048 and 0.025 respectively; For DPNP, the ΔQALYs of mirogabalin compared with placebo and pregabalin were 0.021 and 0.017 respectively. Using the national volume-based procurement price of pregabalin as a reference, with 1 and 3 times the per capita GDP in China (￥89,358, 2023) as thresholds, the daily cost of mirogabalin was found to be cost-effectiveness when it was within 1.64 times (DPNP) or 2.07 times (PHN), 2.47 times (DPNP) or 3.46 times (PHN) of the daily cost of pregabalin. One-way sensitivity showed that, utility values of mild and moderate pain, costs of mirogabalin had the biggest influence on incremental cost-effectiveness ratio. Conclusion: As a novel calcium channel modulator, the cost-effectiveness of mirogabalin is greatly influenced by the reference drug. When pricing in China, it is essential to select appropriate comparator drugs and their prices as references. Key words: cost-effectiveness, mirogabalin, diabetic peripheral neuropathic pain, postherpetic neuralgia

Abstract Background Edaravone has been widely used in amyotrophic lateral sclerosis (ALS) treatment, and a sublingual (SL) tablet has been developed to offer a more convenient alternative for injection. We present a cost-utility analysis to comprehensively evaluate the costs and health outcomes of oral and intravenous edaravone for the treatment of ALS in Chinese medical context. Methods Cost-utility analysis of SL tablets of edaravone versus intravenous edaravone at home was performed by constructing a 20-year Markov model of ALS stage 1–4 and death. The data were extracted from the literature with model assumptions. Typical sensitivity analysis and scenario analysis for administering SL tablets at home versus intravenous tablets at the hospital were performed. Results In the base case analysis, with SL tablets and intravenous injections both at home, the model estimated an additional cost of ¥12,670.04 and an additional 0.034 QALYs over 20 years (life time) of modeling analysis, and the ICER was ¥372,648.24 per QALY. However, in the scenario of intravenous administration at the hospital, SL tablet was demonstrated dominance to intravenous injection. Conclusions Using 3 times the GDP per capita of China in 2023 as the threshold, the SL tablet edaravone was not cost-effective in the context of home treatment for both formulationst, but was dominance to intravenous injection in hospital treatment. The results highlighted the importance of treatment context for health economic analysis.

BackgroundEndoscopic surgery is widely performed with an increasing use of powered vascular staplers (PVS). However, few studies have examined PVS use in China, most of which have focused on clinical effects; fewer studies have examined the economic benefits of PVS. This study evaluated the clinical and economic benefits of the PVS compared to standard-of-care (SOC) staplers in lobectomy using results from a single-arm, multicenter clinical trial conducted in China and actual clinical use in a hospital collected in a real healthcare setting.MethodsPatients with lung cancer undergoing thoracoscopic lobectomy were included in the study. The clinical and economic benefits of powered vascular stapler have been evaluated from a hospital's perspective based on parameters such as bleeding occurrence, hospitalization time, secondary thoracotomy, and hospitalization costs. To compare the bleeding associated with use of PVS and SOC stapler in clinical use, PVS single-arm multi-center clinical trial data is used for the intervention group, and sampling data from hospitals is used for the control group. To ensure the outcome indicators between the two groups are comparable, we set the same inclusion criteria for the two groups of data and then used propensity score matching (PSM) to match two groups of patients according to the baseline characteristics.ResultsThe results show that bleeding incidence in patients with SOC stapler group is 17.33% from hospital sampling data. In contrast, in the PVS group, it is 4.00%, and these rates are statistically different (p = 0.0167). Considering converted to open thoracic surgery, the rate of the SOC stapler group is 5.78% and that of the PVS group is 4.00%. These rates are not statistically different (p = 0.6166). Regarding hospitalization days, the length of the SOC stapler group is 18.97 days, while that in the PVS group is 12.38 days, and these data are statistically different (p = 0.0002). As patients in the PVS group have reduced bleeding, they will require less resource use from blood transfusion, drug services, and surgical services. If PVS is used for transection of vessel, it can reduce the bleeding incidence by 13.33% and save 75.47 CNY in blood transfusion costs, 571.36 CNY in drug costs, and 183.38 CNY in surgical service costs per patient. From these three aspects, the hospital saves per patient 830.21 CNY.ConclusionsCompared with the SOC stapler group, the PVS group has a lower bleeding incidence and shorter hospital days for lobectomy. In terms of blood transfusion costs, drug costs, and surgical service costs, the hospital saves per patient 830.21 CNY.

Health security for rare diseases has aroused much attention in the society nowadays, In this article, we analyzed in-depth the construction of rare diseases health security in China by studying the literature reviews, expert interviews, and reports of pilot policy investigations. We conclude in the study that it is an important step to constructing a multiple health security system for the rare disease making the basic health security as the cornerstone. For rare medications and treatments that cannot be covered by the current national health insurance, it is necessary to build an specific funding for rare disease funding as a means of safeguard. Finally, for those who are financially disadvantages, the system should involve relief and philanthropy to help them. By constructing a multiple health security system, rare diseases patients in our country will get a well-covered health care.

目的:探讨DRG/DIP体系下新医药技术的医保支付机制.方法:基于文献综述和理论研究,梳理总结国内外打包支付下新医药技术支付方式的经验,对我国DRG/DIP体系下医保支付政策设计进行分析.结果:国际上实施DRG支付的国家和地区在新医药技术初期多采用除外支付或设置新分组和费率的方法予以支付,积累充分信息后再将其纳入DRG一般支付体系.我国各地试点经验中的思路与国际经验基本一致,但具体制度流程尚比较模糊,有待进一步完善.结论:我国DRG/DIP体系下新医药技术的医保支付,应在评估筹资能力的基础上,借鉴典型国家和地区的经验,综合考虑短期和长期支付方法,从而对新医药技术给予合理支付.

目的 评价医保续约后德谷门冬双胰岛素对比甘精胰岛素治疗口服降糖药控制不佳中国2型糖尿病患者的经济性.方法 采用医保续约调整后最新医药价格,运用IQVIA CORE糖尿病模型,计算德谷门冬双胰岛素和甘精胰岛素治疗30年的健康产出和卫生成本,并进行增量成本-效果分析.研究基于卫生体系角度,成本包括降糖治疗、疾病管理及并发症治疗的直接医疗成本,健康产出指标为质量调整生命年(quality adjusted life years,QALYs),贴现率使用5%.通过单因素敏感性分析、概率敏感性分析、情境分析验证评价结果的稳健性.结果 基于医保续约调整后的价格,德谷门冬双胰岛素组与甘精胰岛素组比较,治疗2 型糖尿病的成本减少了20 595 元,QALYs增加了0.133,敏感性分析显示基础分析结果稳健.结论 与甘精胰岛素相比,德谷门冬双胰岛素用于口服降糖药控制不佳 2 型糖尿病治疗中可以改善患者健康产出并节约成本,是经济性更优的治疗方案.

目的:规范慢性荨麻疹的药物经济学评价研究方法,提高研究结果的可比性和应用性,以期为临床提供参考.方法:通过检索中英文数据库,收集并归纳整理当前慢性荨麻疹药物经济学评价研究的主要方法,并对慢性荨麻疹的马尔科夫模型结构与特征进行总结.结果:最终纳入符合纳排标准的研究文献32篇,包括中文文献27篇,英文文献5篇.结论:慢性荨麻疹药物经济学研究的中文文献以短期疗效观察为主,英文文献以长期疗效观察或模型推导法为主,后者更注重覆盖长期复发情况,研究多采用社会视角及纳入劳动力损失等全面成本.国内外慢性荨麻疹的药物经济学研究均以抗组胺药为主,而中文文献涉及中药组方和中成药;英文文献中出现了奥马珠单抗等新药.英文文献中较多使用以7日荨麻疹活动度评分(UAS7)为分级依据的马尔科夫模型,通过UAS7评分将慢性荨麻疹分为治愈、稳定以及轻中重等5个等级,全面考虑了治疗后复发与自发性缓解等情况的发生,可以对治疗药物的经济性进行全面体现,值得在相关研究中推广应用.

BackgroundTo investigate the long-term follow-up and economic estimation outcomes of hematoma drainage for spontaneous intracerebral hemorrhage (SICH) with the assistance of neurosurgical navigation and positioning planning system (referred to as robot).MethodsData were retrospectively obtained from consecutive patients with SICH who were admitted to our single-center between March 2019 and March 2022. Different minimally invasive surgery (MIS) procedures were performed according to the inclusion/exclusion criteria. The different groups were sampled and matched using the propensity score method, with age, sex, history of stroke, hypertension, bleeding volume and site of bleeding as matching variables, and matched with inverse probability weighting using R statistical analysis software. From the time of discharge up until 1 year after the surgery, records were gathered on clinical results and medical expenditures. An analysis was conducted to compare the costs and health outcomes of both robot-assisted stereotactic hematoma drainage and neuro-endoscopic surgery, considering both short-term and long-term effects. Health outputs were measured using modified Rankin scale (mRS) and quality adjusted life years (QALYs).ResultsOf the 142 patients, there were 77 patients in the robotic surgery group and 65 patients in the neuro-endoscopic surgery group. Propensity score sampling was matched, resulting in a balanced and comparable group of 37 patients in each, with the robotic surgery group [mean age (57.29 ± 12.74) years, 27 males (72.97%), hematoma volume (44.54 ± 10.49 ml), 22 deep location (59.46%)] and the neuro-endoscopic surgery group [mean age (57.27 ± 11.12) years, 27 males (72.97%), hematoma volume (44.70 ± 10.86 ml), 23 deep location (62.16%)]. At both three-month and one-year postoperative follow-up, the proportion of mRS scores ≤3 was higher in the robotic surgery group (45.95%,70.27%) than in the neuro-endoscopic surgery group (35.14%, 62.16%), but there was no statistically significant difference (P = 0.344, 0.461). One year after surgery, the robotic group demonstrated cost savings of ¥36,862.14 per individual and a gain of 0.062 QALYs compared to the neuro-endoscopic group.ConclusionOur calculations based on a model for SICH suggest that robotic-assisted stereotactic drainage offers health economic benefits due to its lower cost and higher effectiveness. However, to confirm these findings, more data from multicenter, prospective randomized controlled trials with larger sample sizes are needed.

医用耗材价值综合评价是对医用耗材的安全性、有效性、经济性等多维度价值的综合评价,主要目的是为医疗卫生领域中医用耗材有关的决策提供辅助决策支持,以提高决策的科学化、同质化、规范化.本文旨在综述国内外医用耗材价值综合评价方法的研究进展,以期为进一步推动价值综合评价方法在我国医用耗材领域的发展和应用提供借鉴.

Objective:To investigate the clinical efficacy and health economic evaluation of hematoma drainage for spontaneous intracerebral hemorrhage (SICH) with the assistance of neurosurgical navigation and positioning planning system (referred to as robot).Methods:The clinical data and economic data of 199 SICH patients who underwent surgical treatment from March 2019 to March 2022 were collected. All patients were divided into 4 groups according to surgical methods: the robotic surgery group consisted of 77 patients who underwent robot assisted stereotactic hematoma drainage surgery; 65 cases in the neuro-endoscopy groups underwent hematoma removal surgery under neuroendoscopy; 21 cases in the small bone window craniotomy group underwent microscopic hematoma removal with small bone window open; 36 cases in the rigid catheter group underwent CT image-guided free-hand rigid catheter technique. Clinical follow-up outcomes and medical cost from the immediate post-operative to one year period were compared and analyzed. Data from both the robotic surgery and neuro-endoscopy groups were sampled and matched using propensity scoring methods, and health economics were evaluated using modified Rankin scale (mRS) scores and quality adjusted life years (QALYs) indicators.Results:At the time of discharge, there were differences between the groups in terms of operation time, hematoma residual volume, total hospital costs, surgery-related costs, number of days in the ICU, and duration of ventilator use (P<0.05). In the robotic surgery group complication rate of rebleeding was 2.6%, intracranial infection was 1.3%, average hospital stay was 15.45 d, and average hospital cost was ￥46 077.90. There was difference in the proportion of mRS≤3 points between the 4 groups (P<0.05), in which the proportion of patients with mRS≤3 points at 3 months and 1 year after surgery in the robotic surgery group was 55.8% and 74.0%, respectively. Propensity score sampling was matched, resulting in 37 patients each in the balanced and comparable robotic surgery and neuro-endoscopy groups. One year after surgery, the robotic surgery group was able to save ￥36 862.14 per capita and gain 0.062 more QALYs.Conclusion:Based on our model of SICH calculations suggest that robotic-assisted stereotactic drainage has the health economic advantage of being less costly and more effective, further results await multicenter, prospective randomized controlled trials with expanded sample size.

目的 评价筋骨痛消丸对比骨刺片、双氯芬酸钠缓释片治疗膝骨关节炎的成本-效果.方法 基于卫生系统视角,根据疾病治疗转归情况建立决策树模型,采用文献综述及单组率Meta方法获得模型参数,对筋骨痛消丸、骨刺片及双氯芬酸钠缓释片治疗方案进行成本-效果分析,并对参数的不确定性进行敏感性分析.结果 筋骨痛消丸的治疗有效率高于骨刺片(91.70％vs 86.80％),增量成本-效果比(ICER)为3.46元,当每个有效率百分点的意愿支付(WTP)值大于3.40元时,筋骨痛消丸组经济性更优.筋骨痛消丸有效率也高于双氯芬酸钠缓释片(91.70％vs 82.70％),ICER为11.55元,当WTP值大于11.15元时,筋骨痛消丸组经济性更优.结论 筋骨痛消丸对比骨刺片和双氯芬酸钠缓释片治疗膝骨关节炎的效果更优而成本相对较高,在满足一定WTP水平的前提下该药物临床应用具有经济性.

目的 从全社会角度出发,评价渴络欣胶囊联用化学药治疗糖尿病肾病(DKD)的经济性.方法 采用二次文献检索、样本医院病案数据分析、临床专家咨询等方法,构建周期为1年、时限为40年的六状态Markov模型;以质量调整生命年(QALY)为产出指标,贴现率设为5％,并以1倍我国2020年人均国内生产总值(GDP)作为增量成本-效果比(ICER)的判断阈值,评价渴络欣胶囊联用化学药对比单用化学药治疗DKD的经济性.结果 40年间,渴络欣胶囊联用化学药组比单用化学药组人均多花费8644.09元,多获得0.143 QALYs,ICER为60460.25元/QALY,小于1倍我国2020年人均GDP(72447元).敏感性分析结果显示,渴络欣胶囊年用药天数和早期DKD的健康效用值等变量对经济性分析的结果影响较大.概率敏感性分析结果则提示本研究的基线分析结果稳健.结论 在当前价格水平下,相比单用化学药的治疗方案,渴络欣胶囊联用化学药治疗DKD更具有经济性.在决策应用中需要注意渴络欣胶囊用量和患者健康效用值等变量的取值情况.

目的:对盐酸乙酰左卡尼汀对比依帕司他治疗糖尿病周围神经病变(diabetic peripheral neurop-athy,DPN)进行成本效果分析,为相关卫生决策提供科学依据.方法:基于DPN疾病发生发展过程建立马尔可夫模型,采用二次文献研究和专家咨询获得转换概率、成本、效用等相关参数,对盐酸乙酰左卡尼汀与依帕司他治疗DPN的长期成本和健康产出进行经济学评价.结果:成本效果分析结果显示,治疗10年后,研究组的花费比对照组节省2089.69元,多获得0.014个质量调整生命年(QALYs),增量成本效果比值(ICER)为-214090.20元·QALY-1.敏感性分析结果提示,评价结果稳健,并且显示对照组轻度DPN到中重度DPN的转移概率和轻度DPN的健康效用值等变量对ICER结果影响较大.结论:在目前价格水平下,盐酸乙酰左卡尼汀对比依帕司他治疗DPN具有卫生经济性.

目的:探讨硬质灭菌容器、棉布和无纺布3种灭菌包装材料在医院消毒灭菌使用的经济性,为医院制定相关管理决策提供科学参考.方法:使用结构化问卷,采用Delphi专家调查法,对医院内使用硬质灭菌容器、棉布和无纺布在器械再处理流程中的效率、成本和医患感染风险开展调查,并对调查结果进行统计分析,在MS Excel中建立经济学分析模型,计算评估不同灭菌材料的经济性.结果:硬质灭菌容器、棉布灭菌包和无纺布灭菌包的平均总成本分别为20.56元、25.45元和31.47元.硬质灭菌容器、棉布灭菌包和无纺布灭菌包单次消毒工作时间分别为4.78 min、6.42 min和2.95 min.硬质灭菌容器医患感染风险最低,其次为无纺布灭菌包.敏感性分析结果验证基础分析结果的稳健性.结论:消毒灭菌工作中硬质灭菌容器平均总成本最低,感染风险最小,无纺布灭菌包的消毒时间消耗最低,在器械消毒处理流程中应合理选择使用.