2种方案治疗首发精神分裂症的成本-效果分析

目的:评价2种方案治疗首发精神分裂症的成本-效果。方法:对206例住院精神分裂症患者随机采用方案A(给予抗精神病药物联合认知行为疗法)与方案B(给予单纯抗精神病药物)治疗,并进行成本-效果分析。结果:2种方案成本分别为(4460·68±1034·33)元、(3883·32±853·46)元(P<0·05);简明精神病量表减分量(E1)和好转率(E2)分别为(27·23±11·93)、(21·39±9·81)和59·7%、50·6%;平均C/E1分别为163·81元、181·55元,C/E2分别为74·72元、76·75元;与方案B比较,方案A的ΔC/ΔE1为98·86元,ΔC/ΔE2为63·45元。结论:与单纯的抗精神病药物治疗相比,抗精神病药物联合认知行为疗法治疗首发精神分裂症是较为经济的方案,可为选择治疗方案时参考。

Two Therapeutic Schemes for the First Attack of Schizophrenia: Cost - Effectiveness Analysis

OBJECTIVE:To evaluate the cost-effectiveness of two therapeutic schemes in the treatment of the first atˉtack of schizophrenia.METHODS:206inpatients with schizophrenia were randomly assigned to receive antipsychotics plus cognitive behavior therapy(scheme A)or to receive antipsychotics alone(scheme B),the cost-effectiveness of the two schemes was analyzed by the theory of pharmacoeconomics.RESULTS:The costs for scheme A and B were(4460.68±1034.33)yuan and(3883.32±853.46)yuan respectively(P<0.05);The BPRS(brief psychiatric reacting scale)reductions(E 1 )were(27.23±11.93)and(21.39±9.81)respectively,and the improvement rates(E 2 )were59.7%and50.6%respectively.The average cost-effectiveness ratios(C/E 1 )were163.81yuan and181.55yuan respectively,and the ratio of cost to improvement rates(C/E 2 )were74.72yuan and76.75yuan respectively.As compared with scheme B,the incremental cost-effectiveness ratio(ΔC/ΔE 1 )for scheme A was98.86yuan and the ratio ofΔC/ΔE 2 was63.45yuan.CONCLUSION:Antipsychotics is more economical when used concomitantly with cognitive behavior therapy than used alone in treating the first attack of schizophrenia,which can be served as the reference for hospitals in their choice of therapeutic scheme.