3种方案治疗乙型肝炎肝硬化失代偿期患者的成本-效果分析

目的:评价3种方案治疗乙型肝炎肝硬化失代偿期患者的成本-效果。方法:将93例患者随机分为3组,分别单用拉米夫定(LAM)100 mg.d-1,单用阿德福韦酯(ADV)10 mg.d-1,以及联用ADV 10 mg.d-1+LAM 100 mg.d-1,各组均治疗104周。运用药物经济学方法分析其成本-效果。结果:3组谷氨酸氨基转移酶复常率成本-效果比分别为31 952.0,39 504.1,43 958.9;以LAM组为参照,ADV,LAM+ADV组增量成本-效果比为-196500,89097.7。3组HBV DNA转阴率成本-效果比分别为34064.0,42300.8,37961.8;以LAM组为参照,ADV,LAM+ADV组增量成本-效果比为-184 941.2,44 886.4。3组HBeAg/HBeAb转换率成本-效果比分别为120120.3,124155.8,130028.0;以LAM组为参照,ADV,LAM+ADV组增量成本-效果比为149 714.3,146 296.3。结论:阿德福韦酯联合拉米夫定方案为治疗乙型肝炎肝硬化失代偿期患者较优选择。

Cost-effectiveness analysis of 3 therapeutic schemes in the treatment of hepatitis B patients with decompensated cirrhosis

Objective: To evaluate the cost-effect of 3 therapeutic schemes in the treatment of hepatitis B patients with decompensated cirrhosis.Methods: A total of 93 patients were randomly assigned into three groups.Patients received lamivudine(LAM) 100 mg·d-1,adefovir dipivoxil(ADV) 10 mg·d-1,or ADV 10 mg·d-1+LAM 100 mg·d-1 for 104 weeks.Results: In the 3 groups,the cost-effectiveness ratios of serum of alanine aminotransferase normalization rate were 31 952.0,39 504.1 and 43 958.9.As compared with LAM group,the incremental cost-effectiveness ratios of ADV and ADV+LAM groups were-196 500,and 89 097.7,respectively.In the 3 groups,the cost-effectiveness ratios of HBV DNA negative rate were 34 064.0,42 300.8 and 37 961.8.As compared with LAM group,the incremental cost-effectiveness ratios of ADV and ADV+LAM groups were-184 941.2 and 44 886.4,respectively.In the 3 groups,the cost-effectiveness ratios of HBeAg/HBeAb seroconversion rate were 120 120.3,124 155.8 and 130 028.0.As compared with LAM group,the incremental cost-effectiveness ratios of ADV and ADV+LAM groups were 149 714.3 and 146 296.3,respectively.Conclusion: ADV in combination with LAM is more cost-effective in the treatment of hepatitis B patients with decompensated cirrhosis.