抗甲状腺药物短疗程与常规疗程治疗Graves病的费用—效果分析

作者用他巴唑6个月短疗程治疗118例Graves病初发患者,其缓解率(停药1年)为43％。用之与国内常规疗程(1.5～2年)缓解率50％作费用一效果分析。结果显示:每治疗100例患者,其总费用前者为17 746元,后者为30 708.40元;每有效缓解1例,两者分别需412.70元及614.20元,常规疗程可多缓解7例,但需多付12 962.40元.平均1851.80元/例。由此表明用增长疗程来提高有限的缓解率所需费用是很高的,作者认为,对远离医院、经济资源差的地区或农村,可考虑6个月短疗程.对巳经治疗6个月以上的患者,可作预后预测,对其中可能获得延长缓解者,不必采用更长疗程.

Cost-Effectiveness Analysis of Short-Term Course and R egular Course of Antithyroid Drug Therapy for Graves' Disease

One hundred and- eighteennewly diagnosed patients with Graves'disease were treated by tapazole for 6 months(short-term course) and followed up foranother 12 months. Forty three percentremission rate was found in this group. Aregular course of antithyroid drug therapyfor 1.5-2 years with 50% remission rate wastaken as control. Cost-effectiveness ana-lysis was made to compare the cost in thetwo different kinds of therapy. The resultsshowed that the total costs of the treatmentper 100 cases were 17 746 yuan for theshort-term therapy and 30 708 yuan for theregular therapy, with an average of 412.7In comparison with the short-term therapy,the regular course could remit 7 more casesat a cost of 12 962.40 yuan, with anaverageof 1851.80 yuan per case. Therefore, thecost was high by prolonged course of ther-apy to increase slightly remission rate,although it could remit a few more cases.This study suggests that six-month treat-ment is preferable for those who live in therural or remote area where the economy wasless developed. A longer course of thera-py may be unnecessary for those who havebeen treated by antithyroid drugs for 6months or longer and are predicted toobtain a possible prolonged remission.