PCI术后患者抗血小板治疗方案的药物经济学评价

目的 从医疗保险角度，对经皮冠脉支架置入（percutaneous coronary intervention，PCI）术后3种抗血小板药物治疗方案进行经济学评价。方法 3种治疗方案为在使用阿司匹林基础上，经验性给予国产氯吡格雷，或经验性给予替格瑞洛，或根据CYP2C19基因型指导选择国产氯吡格雷或替格瑞洛，由此建立决策树模型并进行成本效果分析，预测该3种方案避免主要心血管事件的发生率以及成本，研究时间为1年。结果 经验性给予国产氯吡格雷联合阿司匹林治疗方案为成本最低方案，但直接给予替格瑞洛联合阿司匹林治疗方案的经济性最好。结论 对于PCI术后的患者，最推荐直接采用替格瑞洛联合阿司匹林的治疗方案。

Pharmaceconomical Efficacy Analysis of Antiplatelet Therapies in Patients after PCI

OBJECTIVE To compare the pharmaceconomical efficacy of three antiplatelet treatments after percutaneous coronary intervention (PCI) from the perspective of health care.METHODS Patients were given domestic clopidogrel routinely, ticagrelor routinely,domestic clopidogrel or ticagrelor guided by CYP2C19 genotype testing,which all were combined with aspirin.A decision-analytic model was established to predict the rate of avoiding the major cardiovascular event and cost and the following time was one year.RESULTS Although the treatment of domestic clopidogrel plus aspirin routinely was the lowest cost option,the cost-effectiveness of ticagrelor combined with aspirin routinely was the best.CONCLUSION Routine ticagrelor combined with aspirin is recommended for patients after PCI.