持续皮下胰岛素输注和胰岛素每日多点注射治疗2型糖尿病的成本效果分析

目的 比较新人院的2型糖尿病患者使用持续皮下胰岛素输注(CS Ⅱ)和胰岛素每日多点注射(MDI)控制2型糖尿病血糖达标的成本效果.方法 回顾性分析86例使用CS Ⅱ方案和103例使用MDI方案控制血糖的新入院2型糖尿病患者,观察时间为2周.运用药物经济学中的成本效果分析法对两种治疗方案进行评价.结果 治疗2周后,CS Ⅱ组与MDI组患者血糖控制有效率相似,差异无统计学意义(P>0.05);CS Ⅱ组低血糖反应发生率及夜间低血糖发生率较MDI组明显降低(P<0.05),其他不良反应发生率相似;CS Ⅱ方案成本(元/人)比MDI方案低(1478.34 vs.1620.46),差异有统计学意义(P<0.05);成本效果比(C/E)显示CS Ⅱ组为15.07,MDI组为16.34,差异无统计学意义(P>0.05);冉以成本较低的CS Ⅱ组方案为参照,增量的成本效果比(AC/AE)MDI组为129.20.结论 使用CS Ⅱ方案控制新人院2型糖尿病患者治疗的成本效益较MDI方案好,CS Ⅱ方案是住院期间胰岛素强化治疗的较优选择.

Cost-effectiveness analysis on continuous subcutaneous insulin infusion and multi-point daily insulin injections in the treatment program of type 2 diabetes

Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion (CS Ⅱ) and multi-point daily insulin injections (MDI) in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a 'blood sugar control program' among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CS Ⅱ group was similar to the MDI group, with no significant difference(P<0.05) and the adverse reactions were similar. Costs in the CS Ⅱ program (Yuan/person) was less than in the MDI program (1478.34 vs. 1620.46), with significant differences (P< 0.05). The cost-effectiveness ratios (C/E) were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference (P>0.05). In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio (△C/ △E)ofthe MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.