3种核苷类药物治疗慢性乙型肝炎的成本-效果分析

目的评价3个核苷类药物（拉米夫定、阿德福韦和恩替卡韦）治疗慢性乙型肝炎的成本-效果。方法运用药物经济学成本-效果分析方法对151例慢性乙型肝炎的3个治疗组（A组：拉米夫定治疗;B组：阿德福韦治疗;C组：恩替卡韦治疗）进行回顾性分析评价。结果从肝组织学改善率、ALT复常率、HBeAg消失率、HBeAg血清转换率和HBV DNA转阴率的百分比中评定3组药物的疗效,恩替卡韦效果最佳,而拉米夫定的成本-效果比最低。结论在慢性乙型肝炎患者治疗方案选择上应优先考虑拉米夫定或阿德福韦,并根据患者临床指标的差异具体选择某一治疗方案。当患者经济条件许可、上述疗效不佳时可选用恩替卡韦。

Cost-effectiveness analysis of 3 different nucleoside drugs for chronic hepatitis B

OBJECTIVE To evaluate the cost-effectiveness of 3 different nucleoside drugs for chronic hepatitis B.METHODS Using pharmacoeconomic cost-effectiveness analysis on 3 different nucleoside drugs（group A of Lamivudine, group B of Adefavir, group C of Entecavir） for 151 cases chronic hepatitis B, were retrospectivly evaluated. RESULTS In unit effect of hepatic-tissue changing, decreasing ALT, HBeAg negative conversion, HBeAg negative canversion in serum and HBV DNA negatire conversion, Entecavir was the best of all. But in cost-effectiveness analysis, the expenses of Lamivudine was lowest of all. CONCLUSION Lamivudine and Adefovir for Chronic Hepatitis B should be chosed preferentially, as well as according to difference of clinical specific indexes. Entecavir could also be used when the money was enough and the other two above-mentioned was unsatisfact.