慢性乙肝3种治疗方案疗效及成本-效果分析

目的探讨3种治疗慢性乙型肝炎方案的临床疗效及所产生的经济效果。方法运用药物经济学成本-效果分析方法对96例慢性乙型肝炎的3种治疗方案(A组:拉米夫定治疗;B组:苦参素治疗;C组:膦甲酸钠治疗)进行回顾性分析评价。结果在ALT复常率方面,B、C组复常率(分别为82.76%和76.00%)明显高于A组(57.14%),P<0.05;HBeAg阴转率方面,B、C组(分别为31.03%、48.00%)明显高于A组(16.67%),P<0.05;在HBV-DNA阴转率方面,A组(85.71%)明显高于B、C组(分别为48.28%,68.00%),P<0.05。从成本-效果比看,在获得相同ALT复常率、HBeAg转阴率效果时B组花费的成本最低(67.0元和178.7元),在获得相同HBV-DNA转阴率时A组花费的成本最低(87.7元)。结论在慢性乙型肝炎患者治疗方案选择上应优先考虑苦参素或拉米夫定,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膦甲酸钠。

Efficacy and Cost-Effectiveness Analysis of 3 Different Therapeutic Schemes for Chronic Hepatitis B

Objective To explore the clinical efficacy and the economic effectiveness of three different therapeutic schemes for chronic hepatitis B.Methods Using pharmaconomical cost-effectiveness analysis on three therapeutic schemes(group A of lamivudine,group B of matrine,and group C of foscarnet sodium)for 96 cases chronic hepatitis B,were retrospectivly evaluated .Results In unit effect of decreasing ALT,the ratio of groupB and group C(82.76% and 76%,respectively) were obviously higher than that of group A(57.14%),P<0.05;in unit effect of HBeAg negative conversion,groupA was the lowest(16.67%),P<0.05,compared with groupB and C(31.03% and 48%,respectively);in unit effect of HBV-DNA negative conversion,groupA was the highest((85.71%)),P<0.05,compared with group B and C(48.28% and 68%,respectively);by pharmaconomical cost-effectiveness analysis,the expenses of group B cost in the similar effect of decreasing ALT,HBeAg negative conversion was lowest(67.0yuan and178.7yuan respectively),but the expenses of group A cost in the similar effect of HBV-DNA negative conversion was lowest(87.7yuan).Conclusion The therapeutic scheme B and A for Chronic Hepatitis B should be chosed preferentially,as well as according to difference of clinical specific indexes.Therapeutic scheme C could also be used when the money was enough and the therapeutic effect above-mentioned was unsatisfactory.