氟西汀治疗持续的躯体形式疼痛障碍的成本-效果分析

目的 初步探索氟西汀治疗持续的躯体形式疼痛障碍(PSPD)的成本-效果分析.方法 将80例PSPD患者随机分为氟西汀组和安慰剂组,每组各40例,分别服用氟西汀胶囊(20 ms/d)和安慰剂胶囊(1粒/d)8周,研究者和患者双肓.调查入组前后直接医疗成本,计算两组患者入组前后共4个月的成本与效果比值.结果 (1)氟西汀组有效率为40%,安慰剂组有效率为8%.(2)氟西汀组和安慰剂组成本与效果比值分别为0.53万元(5345元)和1.83万元(18 345元).(3)敏感度分析,氟西汀组和安慰剂组的成本与效果比值分别为0.40万元(4033元)和1.22万元(12 188元).结论 应用氟西汀治疗PSPD的成本与效果比值较低,具有较好的药物经济学价值.

Cost-effectiveness analysis of fluoxetine for patients with persistent somatoform pain disorder

Objective The objective of this study was to analyze cost-effectiveness ratio of fluoxetine as a treatment for patients suffering from persistent somatoform pain disorder.Methods This study was a randomized,double-blind,placebo-controlled study.Patients(n=80)with persistent somatoform pain disorder for 6-120 months were recruited.Patients were randomly allocated to receive fluoxetine(20 ms/d)or placebo(1 tab/d)for 8 weeks.The primary clinical outcome was the Medical Outcomes Study Pain Measures(MOSPM).Direct medical costs were measured from patients and their family for total experiment duration and the previous 2 months.Effectiveness was measared with responsive rate.Difierenees in costs between both groups prior to the trial were not statistically significant.Results The responsive rate in fluoxetine group was 40%(16/40),and 8%(3/40)in placebo group.Costeffectiveness ratio analysis showed that every patient spent 5345 yuan and 18 345 yuan to acquire 1%responsive rate in fluoxetine group and placebo group respectively.Sensitivity analysis result showed that patient in fluoxetine group needed 4033 yuan and patient in placebo group needed 12 188 yuan to acquire 1%responsive rate.Conclusion For persistent somatoform pain disorder,fluoxefine is more cost-effective than placebo.