Combined bailing capsule and conventional therapies in the treatment of chronic renal failure: a meta-analysis and economic evaluation

IntroductionBailing capsules are currently recommended for improving renal function in patients with chronic renal failure (CRF) in China. However, limited research assesses the clinical benefits of Bailing capsules in the context of healthcare resource utilization. Therefore, we conducted this stud...

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Main Authors: Yumei He, Wei Li, He Zhu, Sheng Han
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1609311/full
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author Yumei He
Yumei He
Wei Li
Wei Li
He Zhu
He Zhu
Sheng Han
Sheng Han
author_facet Yumei He
Yumei He
Wei Li
Wei Li
He Zhu
He Zhu
Sheng Han
Sheng Han
author_sort Yumei He
collection DOAJ
description IntroductionBailing capsules are currently recommended for improving renal function in patients with chronic renal failure (CRF) in China. However, limited research assesses the clinical benefits of Bailing capsules in the context of healthcare resource utilization. Therefore, we conducted this study to compare the efficacy of Bailing capsules combined with conventional therapies and to assess their economic value from the Chinese healthcare system perspective.MethodsFor the meta-analysis, six bibliographic databases were systematically searched for eligible randomized controlled trials (RCTs) from their inception until May 2025. For the economic evaluation, a Markov model was established to simulate the disease progression of patients over 20 years. The incremental cost-effectiveness ratio (ICER) was measured, and one-way and probabilistic sensitivity analyses were performed to observe model stability.ResultsThe use of Bailing capsules combined with conventional therapies was associated with a significant reduction in serum creatinine compared to conventional therapies alone (weighted mean difference [WMD]: –36.73 μmol/L; 95% confidence interval [CI]: –45.06 to –28.40; p < 0.001, n = 1,380 patients from 17 RCTs). Moreover, Bailing capsules combined with conventional therapies were associated with lower blood urea nitrogen (WMD: –2.52 mmol/L; 95% CI: –3.83 to –1.22; p < 0.001) and 24 h urinary protein (WMD: –0.39 g/L; 95% CI: –0.47 to –0.30; p < 0.001) levels than conventional therapy alone. However, no significant difference existed between Bailing capsules combined with conventional therapies and conventional therapy alone in terms of creatinine clearance rate (WMD: 4.81 mL/min; 95% CI: –0.45 to 10.06; p = 0.073). In the economic evaluation, combination therapy yielded 0.92 additional quality-adjusted life-years (QALYs) and incurred additional costs of Chinese Yuan (CNY) 21,335 over a 20-year horizon, resulting in an ICER of CNY 23,312 per QALY gained. This ICER was below China’s willingness-to-pay threshold of CNY 85,698 (2022 gross domestic product per capita). Sensitivity analyses confirmed the robustness of the results, with the combination therapy showing a 94% probability of cost-effectiveness at the threshold (probabilistic sensitivity analysis).DiscussionBailing capsules combined with conventional therapies are associated with a greater reduction in serum creatinine and are likely to be cost-effective for patients with CRF in China.
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spelling doaj-art-352dc5cbc0be4377bbd091b02bcc372f2025-08-20T03:26:31ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.16093111609311Combined bailing capsule and conventional therapies in the treatment of chronic renal failure: a meta-analysis and economic evaluationYumei He0Yumei He1Wei Li2Wei Li3He Zhu4He Zhu5Sheng Han6Sheng Han7International Research Center for Medicinal Administration, Peking University, Beijing, ChinaSchool of Pharmaceutical Sciences, Peking University, Beijing, ChinaInternational Research Center for Medicinal Administration, Peking University, Beijing, ChinaSchool of Pharmaceutical Sciences, Peking University, Beijing, ChinaInternational Research Center for Medicinal Administration, Peking University, Beijing, ChinaSchool of Pharmaceutical Sciences, Peking University, Beijing, ChinaInternational Research Center for Medicinal Administration, Peking University, Beijing, ChinaSchool of Pharmaceutical Sciences, Peking University, Beijing, ChinaIntroductionBailing capsules are currently recommended for improving renal function in patients with chronic renal failure (CRF) in China. However, limited research assesses the clinical benefits of Bailing capsules in the context of healthcare resource utilization. Therefore, we conducted this study to compare the efficacy of Bailing capsules combined with conventional therapies and to assess their economic value from the Chinese healthcare system perspective.MethodsFor the meta-analysis, six bibliographic databases were systematically searched for eligible randomized controlled trials (RCTs) from their inception until May 2025. For the economic evaluation, a Markov model was established to simulate the disease progression of patients over 20 years. The incremental cost-effectiveness ratio (ICER) was measured, and one-way and probabilistic sensitivity analyses were performed to observe model stability.ResultsThe use of Bailing capsules combined with conventional therapies was associated with a significant reduction in serum creatinine compared to conventional therapies alone (weighted mean difference [WMD]: –36.73 μmol/L; 95% confidence interval [CI]: –45.06 to –28.40; p < 0.001, n = 1,380 patients from 17 RCTs). Moreover, Bailing capsules combined with conventional therapies were associated with lower blood urea nitrogen (WMD: –2.52 mmol/L; 95% CI: –3.83 to –1.22; p < 0.001) and 24 h urinary protein (WMD: –0.39 g/L; 95% CI: –0.47 to –0.30; p < 0.001) levels than conventional therapy alone. However, no significant difference existed between Bailing capsules combined with conventional therapies and conventional therapy alone in terms of creatinine clearance rate (WMD: 4.81 mL/min; 95% CI: –0.45 to 10.06; p = 0.073). In the economic evaluation, combination therapy yielded 0.92 additional quality-adjusted life-years (QALYs) and incurred additional costs of Chinese Yuan (CNY) 21,335 over a 20-year horizon, resulting in an ICER of CNY 23,312 per QALY gained. This ICER was below China’s willingness-to-pay threshold of CNY 85,698 (2022 gross domestic product per capita). Sensitivity analyses confirmed the robustness of the results, with the combination therapy showing a 94% probability of cost-effectiveness at the threshold (probabilistic sensitivity analysis).DiscussionBailing capsules combined with conventional therapies are associated with a greater reduction in serum creatinine and are likely to be cost-effective for patients with CRF in China.https://www.frontiersin.org/articles/10.3389/fmed.2025.1609311/fullchronic renal failureBailing capsulesMarkov modelcost-effectiveness analysisChinese population
spellingShingle Yumei He
Yumei He
Wei Li
Wei Li
He Zhu
He Zhu
Sheng Han
Sheng Han
Combined bailing capsule and conventional therapies in the treatment of chronic renal failure: a meta-analysis and economic evaluation
Frontiers in Medicine
chronic renal failure
Bailing capsules
Markov model
cost-effectiveness analysis
Chinese population
title Combined bailing capsule and conventional therapies in the treatment of chronic renal failure: a meta-analysis and economic evaluation
title_full Combined bailing capsule and conventional therapies in the treatment of chronic renal failure: a meta-analysis and economic evaluation
title_fullStr Combined bailing capsule and conventional therapies in the treatment of chronic renal failure: a meta-analysis and economic evaluation
title_full_unstemmed Combined bailing capsule and conventional therapies in the treatment of chronic renal failure: a meta-analysis and economic evaluation
title_short Combined bailing capsule and conventional therapies in the treatment of chronic renal failure: a meta-analysis and economic evaluation
title_sort combined bailing capsule and conventional therapies in the treatment of chronic renal failure a meta analysis and economic evaluation
topic chronic renal failure
Bailing capsules
Markov model
cost-effectiveness analysis
Chinese population
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1609311/full
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