二甲双胍分别配伍4种降糖药方案治疗2型糖尿病的成本-效果分析

 目的 评价我院常用二甲双胍联合4种口服降糖药治疗2型糖尿病的临床疗效及经济成本.方法 运用药物经济学原理对二甲双胍+格列齐特(A)、二甲双胍+罗格列酮(B)、二甲双胍+阿卡波糖(C)、二甲双胍+瑞格列奈(D) 4种用药方案进行成本-效果分析.结果 A、B、C、D方案总有效率分别为87.5%、88.57%、94.67% 和 86.67%.经统计学检验差异无统计学意义(P>0.05);总成本分别为(204.8±41.1)元、(246.8±60.5)元、(271.6±55.9)元和(255.5±46.3)元,A方案成本低于B,C,D(P<0.05),而B,C,D三方案间总成本差异无统计学意义(P>0.05),C方案增量成本-效果比值最低.结论 C方案效果最好但成本高,A方案经济性较佳.

Cost- effectiveness analysis of metformin combined with four hypoglycemic drugs for treating type 2 diabetes mellitus

Objective To evaluate the clinical and economic effect of four hypoglycemic drugs for type 2 diabetes mellitus. Methods The cost - effectiveness analysis was conducted using pharmacoeconomical principles on the four therapeutic schemes ： metformin ＋ gliclazide （scheme A）, metformin ＋ acarbose （scheme C）, metformin ＋ rosiglitazone （scheme B）, metfonnin ＋ repaglinide （scheme D）. Results The total effective rate of scheme A , B , C and D was 87.5 % ,88.57% ,94.67% and 86.67%, respectively, and there were no significant differences between them（ P 〉 0.05 ）. The total cost of the four schemes was （204.8 ± 41.1 ） yuan , （ 246.8 ± 60.5 ） yuan, （271.6 ± 55.9） yuan and （255.5 ±46.3 ） yuan respectively, The total cost of Scheme A was significantly lower than that of Scheme B, C, and D （ P 〈 0.05 ）, which had no significant difference （ P 〉 0.05 ）. In addition, the incremental cost - effectiveness ratio of Group C was minimum. Conclusions Among the four schemes, Scheme C is effective but costly; Scheme A is the optimal one for type 2 diabetes mellitus in pharmacoeconomics.