Traditional Chinese medicine in treating Corona Virus Disease 2019: a systematic review and cost-effectiveness analysis

Abstract

ABSTRACT
 Background: Currently, corona virus disease 2019 (COVID-19) has infected 633,601,048 people worldwide according to World Health Organization, which leads to huge disease burden. A considerable number of trials of traditional Chinese medicine (TCM) have been carried out and have shown the efficacy of TCM in the treatment of COVID-19, but their cost-effectiveness has not been studied, especially in China. Therefore, we plan to perform a systematic review and cost-effectiveness analysis to explore the cost-effectiveness of using TCM in treating COVID-19.
 Methods: A systematic review based on previously published secondary data from randomized controlled trials and observational studies which included TCM as one of the interventions for patients with COVID-19 will be performed. Patients with COVID-19 will be classified into five specific groups (patients without diagnosis; patients with mild, moderate, severe and critical symptoms). TCM versus western medicine on both effectiveness outcomes(cure rate and survival rate) and utility outcome(quality-adjusted life years) will be evaluated. A decision tree model will be established taking the perspective of Chinese health care system since the costs were paid by the Chinese government. Cumulative costs, Qalys, and incremental cost-effectiveness ratio will be selected as the outcome indicator. Sensitivity analysis will also be conducted to evaluate the impact of parameter uncertainty on the base-case analyses results. We will present results at various willingness-to-pay thresholds using a cost-effectiveness acceptability curve.
 Discussion We hope to demonstrate the cost-effectiveness of TCM, see an improvement in the patients' quality of life, achieve a improvement in the cure rate and survival rate of COVID-19. If TCM is cost-effectiveness, it could be applied to clinical practice decision making.
 Ethics and dissemination: Ethics approval is not required for the current study. Because the data used in this study is just the re-use of data which are already in the public domain. The results will be disseminated to general public, clinicians, academics and policy makers.
 Registration number: CRD42021228887
 Keywords: Traditional Chinese medicine; Corona Virus Disease 2019; decision tree model; systematic review; cost-effectiveness analysis