非霍奇金淋巴瘤三种化疗方案成本 效果分析

目的:探讨治疗非霍奇金淋巴瘤联合化疗最佳方案及用药合理性.方法:根据文献选择68例患者,随机分为3组,分别给予以吡喃阿霉素(THP)、表阿霉素(E ADM)、阿霉素(ADM)为主的联合化疗方案,运用药物经济学成本 效果分析方法进行评价.结果:3组不同化疗方案中完全缓解率(CR%)以E ADM组最高,不良反应发生总例次THP组最低,心脏毒性及脱发3组间差异有显著性.结论:应根据患者体质、经济条件等具体情况,适宜地制订给药方案.     

Innovative approaches in the treatment of emesis

Over the last 15 years, appreciation of the role of dopaminergic (D₂) receptors and serotonergic (5-HT₃) receptors has led to the development of a series of highly effective antiemetic agents. However, in spite of the suggestion of additional significant receptors (such as the NK-1 receptor and the opiate receptor), recent innovations in antiemetic treatment have concentrated on refinement of schedule, route, and dose. Singledose regimens and oral formulations improve the convenience of antiemetic administration, while identification of the minimum effective dose has important economic implications. Involvement of experienced supportive care investigators in objective determination of utility scores for various supportive care modalities will be vital for rational inclusion of supportive care in pharmacoeconomic analysis, critical pathways, and clinical guidelines.Presented as an invited lecture at the 8th International Symposium: Supportive Care in Cancer, Toronto, Canada, 19–22 June 1996     

Drug price,dosage and safety: Real-world evidence of oral hypoglycemic agents

ObjectivesDrug price reduction is one of the major policies to restrain pharmaceutical expenses worldwide. This study explores whether there is a relationship between drug price and clinical quality using real-world data.MethodsPatients with newly-diagnosed type 2 diabetes receiving metformin or sulfonylureas during 2001 and 2010 were identified using the claim database of the Taiwan universal health insurance system. Propensity score matching was performed to obtain comparable subjects for analysis. Pharmaceutical products were categorized as brand-name agents (BD), highpriced generics (HP) or low-priced generics (LP). Indicators of clinical quality were defined as the dosage of cumulative oral hypoglycemic agents (OHA), exposure to other pharmacological classes of OHA, hospitalization or urgent visit for hypoglycemia or hyperglycemia, insulin utilization and diagnosis of diabetic complications within 1 year after diagnosis.ResultsA total of 40,152 study subjects were identified. A generalized linear mix model showed that HP and BD users received similar OHA dosages with comparable clinical outcomes. By contrast, LP users had similar outcomes to BD users but received a 39% greater OHA dosage. A marginally higher risk of poor glycemic control in LP users was also observed.ConclusionsDrug price is related to indicators of clinical quality. Clinicians and health authorities should monitor the utilization, effectiveness and clinical safety indicators of generic drugs, especially those with remarkably low prices.     

外用止痛贴膏的药物经济学评价方法探讨

通过对外用止痛贴膏的市场和药物特点进行分析,对其治疗方案的成本和产出进行探讨,旨在说明对外用止痛贴膏进行药物经济学评价的必要性,讨论出适用于外用止痛贴膏的药物经济学评价方法。     

4种给药方案治疗子宫肌瘤的成本-效果分析

目的:探讨治疗子宫肌瘤4种给药方案的经济学效果。方法:运用药物经济学原理对复方醋酸棉酚(A组)、米非司酮(B组)、复方醋酸棉酚+米非司酮(C组)、桂枝茯苓胶囊(D组)4种给药方案的成本-效果进行分析。结果:4组成本分别是1 336、400、868、947元;有效率分别是83.3%、64.9%、91.4%、55.6%;成本-效果比分别是16.0、6.2、9.5、17.0;A、C、D组相对于B组的增量成本-效果比分别是50.9、17.7、-58.8。结论:C组治疗子宫肌瘤最佳。     

头孢哌酮/舒巴坦钠与亚胺培南/西司他丁钠治疗肺部感染最小成本分析

目的:评价头孢哌酮/舒巴坦钠(舒普深,CPZ-SB)与亚胺培南/西司他丁钠(泰能I,MP)治疗肺部感染的经济学效果。方法:运用最小成本分析法,对分别以2种治疗方案治疗肺部感染的临床疗效及成本进行评价。结果:CPZ-SB组和IMP组总有效率分别为92.68%、78.05%,细菌清除率分别为57.14%、50%,均无统计学意义(P>0.05)。CPZ-SB组和IMP组的治疗成本分别为3 184.55、1 732.65元,成本-效果比分别为34.362、2.20。结论:从药物经济学角度看I,MP组方案较佳。     

米曲菌胰酶片治疗功能性消化不良的上市后药物经济学评价

目的:对米曲菌胰酶片治疗功能性消化不良的成本-效果进行分析。方法:收集多中心非随机同期病例数据,采用成本-效果分析对其进行药物经济学评价。结果:米曲菌胰酶片组相对于对照组(非米曲菌胰酶片治疗),每增加1个效果单位,成本可节约768.52元。使用米曲菌胰酶片治疗可通过提高治疗效果而降低病人的总费用。结论:米曲菌胰酶片治疗功能性消化不良有效、经济。     

药物经济学在医院药品目录调整中的应用

目的:探讨药物经济学在医院药品目录调整中的应用方法和效果。方法:通过医院运用药物经济学原理调整药品目录的实践,提出不断优化医院药品目录的方法和途径。结果:运用药物经济学原理调整医院药品目录,可以进一步优化药品种类、降低药品使用费用、降低药占比。结论:运用药物经济学原理对医院药品目录进行遴选,有利于降低医院药品费用,减轻患者的负担,同时也有助于规范医院诊疗行为,杜绝各种不良的用药现象。     

三种治疗原发性高血压降压药的成本-效果分析

目的对常用的三种抗高血压药厄贝沙坦、依那普利、美托洛尔进行成本-效果分析。方法选择2010年1月～2011年1月郴州市第一人民医院门诊高血压患者180例为研究对象,并随机分为三组,分别服用抗高血压药厄贝沙坦、依那普利、美托洛尔,疗程12周,根据疗效进行成本-效果分析。结果厄贝沙坦、依那普利组疗效优于美托洛尔组(P<0.05);成本-效果分析,费用效果比最优为厄贝沙坦组。结论药物经济学在为高血压患者合理选药、为患者提高依从性和控制达标率、显著改善患者的生存质量、有效降低疾病负担等方面具有重要意义。     

左氧氟沙星与加替沙星治疗下呼吸道感染的药物经济学分析

目的评价左氧氟沙星与加替沙星治疗下呼吸道感染的成本-效果分析。方法将70例下呼吸道感染患者随机分为左氧氟沙星组35例和加替沙星组35例,观察两组的疗效、不良反应。结果左氧氟沙星组和加替沙星组总有效率分别为97.14%和97.14%,差异无统计学意义(P>0.05);治疗成本分别1789.92元和2052.16元;左氧氟沙星组成本效果比(C/E)为18.43,加替沙星组成本效果比(C/E)为21.13。结论使用左氧氟沙星治疗下呼吸道感染是一种较好方案。