3种肝病药治疗慢性乙型肝炎的成本-效果分析及长远治疗方案

目的:分析3种肝病药治疗慢性乙型肝炎的成本-效果,为慢性乙肝的治疗寻找一种经济、有效的治疗方案。方法:将210例慢性乙型肝炎患者随机分为3组,A组予拉米夫定100 mg,qd;B组予恩替卡韦0.5 mg,qd;C组予阿德福韦酯10 mg,qd。疗程均为48周。观察3组患者的疗效和不良反应,应用药物经济学成本-效果分析法进行评价。结果:A、B、C组的成本分别为5 711.60、13 126.00、6 834.20元,HBV-DNA转阴率分别为47.14%、78.57%、31.40%,成本-效果比分别为121.16、167.06、217.65,B、C组相对于A组的增量成本-效果比分别为235.90、-71.32。结论:从长远的抗病毒治疗考虑,高疗效、低耐药性的恩替卡韦应是一种更为合理的治疗方案。

Cost-effectiveness Analysis and Long-term Treatment Plan of 3 Kinds of Drug for Liver Disease for Chronic Hepatitis B

OBJECTIVE： To analyze the cost-effectiveness of 3 kinds of drug for liver disease for chronic hepatitis B, and to find economical and effective therapeutic schedule for chronic hepatitis B. METHODS： 210 cases of chronic hepatitis B were randomly divided into 3 groups. Group A was given lamivudine 100 mg, qd; group B was given entecavir 0.5 rag, qd; group C was given adefovir dipivoxil 10 rag, qd. The treatment course lasted for 48 weeks. Therapeutic efficacy and ADR were observed in 3 groups, and evaluated by using pharmacoeconomics cost-effectiveness analysis. RESULTS： The costs of group A, B and C were 5 711.60 yuan, 13 126.00 yuan and 6 834.20 yuan; HBV-DNA negative conversion ratios of 3 groups were 47.14% , 78.57% and 31.40%, respectively. The cost-effectiveness ratios of 3 groups were 121.16, 167.06 and 217.65, respectively. The incremental cost-effectiveness ratios of group B and C to group A were 235.90 and --71.32. CONCLUSIONS： From the respective of long-term antiviral treatment, entecavir with high curative effect and low resistance should be a more reasonable treatment plan.