Abstract: ObjectiveTo investigate the pharmacoeconomics of anti-inflammatory and hepatoprotective drugs in treatment of nonalcoholic fatty liver disease (NAFLD). Methods Decision tree analysis model was carried out in the study, based on rate parameters from meta-analysis, efficacy parameters from expert opinions, as well as cost parameters (drug specifications, dosage and unit price) from the literature, expert opinion and real-time drug prices in Guangzhou, etc. The pharmacoeconomics analysis were performed among 7 treatment regimens for 24 weeks as followed: reduced glutathione tablets (Alto Moran), diammonium glycyrrhizinate capsules (Tianqing Ganping), metformin hydrochloride tablets (Gehua only), silybin capsules (Water forest good), bicyclol tablets (Pisanuo), tiopronin enteric-coated tablets (Kesi Lai) and polyene phosphatidylcholine capsules (Yi Shan Fu). Results Patients with bicyclol tablets treatment showed higher (8.80) therapeutic effect than those with reduced glutathione tablets (5.70), diammonium glycyrrhizinate capsules (7.40), metformin hydrochloride tablets (7.10), silybin capsules (8.00), tiopronin enteric-coated tablets (6.80) and polyenoic phosphatidylcholine capsules (7.00), respectively. The average cost-effectiveness ratio was the lowest (166.97) in metformin hydrochloride tablets, but the highest in diammonium glycyrrhizinate capsules (504.97). Incremental cost-effectiveness ratio of bicyclol tablets was 1219.97, which was lowest among the 7 groups. In terms of efficiency, bicyclol tablets had significantly highest (58.00%) efficacy among the 7 groups, and the incremental cost-effectiveness ratio of bicyclol tablets compared with metformin hydrochloride tablets was 32.21. This result was confirmed by sensitivity analysis. Conclusion Bicyclol tablets is effective in the treatment of NAFLD with a significantly cost-effective advantage.

Key words: Nonalcoholic fatty liver disease, Anti-inflammatory hepatoprotective drugs, Pharmacoeconomics, Decision tree model