5种口服降糖药治疗2型糖尿病的药物经济学分析

目的比较5种不同口服降糖药治疗2型糖尿病的经济效果。方法采用药物经济学中的成本-效果分析（CEA）法对采用二甲双胍（A组）、进口阿卡波糖（B组）、国产阿卡波糖（C组）、罗格列酮（D组）、格列吡嗪（E组）、瑞格列奈（F组）治疗2型糖尿病的方案进行分析。结果A，B，C，D，E，F组的药物成本分剐为14．56，421．68，317．52，680．96，67．20，280．00元；控制空腹血糖的总有效率分别为81．63％，88．46％，89．36％，86．36％，84．00％，83．33％；成本-效果比分别为0．18，4．77，3．55，7．89，0．80，3．36；控制餐后2h血糖的总有效率分别为75．51％，88．46％，89．36％，88．64％，88．00％，79．17％；成本-效果比分别为0．19，4．77，3．55，7．68，0．76，3．54。结论在以控制空腹血糖为主要目标时选择二甲双胍更经济，而以控制餐后2h血糖或以控制餐后血糖为主要目标时选择格列吡嗪更合理。

Analysis on Pharmaceutical Economics of Different Oral Antidiabetic Drugs for Treating Type-2 Diabetes Mellitus

Objective To compare the economical effectiveness of 5 different oral antidiabetic drugs for treating type- 2 diabetes mellitus （DM）. Methods Using cost- effectiveness analysis（CEA） on pharmaceutical economics, to compare the cost effectiveness of the 6 randomized groups, in which, group A, B, C, D, E and F was treated with metformin, imported acarbose, domestic acarbose, rosiglitazone, glipizide and repaglinide respectively. Results The costs for group A, B, C, D, E and F were 14. 56, 421.68, 317.52, 680.96, 67.20 and 280. 00 Yuan respectively; the total effective rates of controlling fasting blood glucose were 81.63%, 88.46%, 89. 36%, 86. 36%, 84.00% and 83.33% respectively, the cost - effectiveness ratios were 0. 18, 4. 77, 3.55, 7.89, 0. 80 and 3.36 respectively; the total effective rates of controlling 2 h postprandial blood glucose were 75.51%, 88.46%, 89.36%, 88.64%, 88.00% and 79. 17% respectively, the cost - effectiveness ratios were 0. 19, 4. 77, 3.55, 7.68, 0. 76 and 3.54 respectively. Conclusion According to the method of cost - minimization analysis, it is more economic to use mefformin to control fasting blood glucose level while it is more reasonable to use glipizide to control the level of postprandial blood glucose or take the controlling of postprandial blood glucose as priority.