今日药学

2016, v.26(10) 728-731

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恩替卡韦与聚乙二醇干扰素α-2a治疗慢性乙型肝炎1年和5年的成本-效果分析
Cost-effectiveness Analysis of Entercavir and Pegylated-Interferon α-2a for The Treatment of Chronic Hepatitis B for one Year and five Years

廖云珍;叶晓光;周俊;
LIAO Yunzhen;YE Xiaoguang;ZHOU Jun;Department of Infectious Diseases,the Second Affiliated Hospital of Guangzhou Medical College;

摘要(Abstract):

目的对恩替卡韦与聚乙二醇干扰素α-2a 治疗慢性乙型肝炎进行短期和长期的成本-效果分析,找出适合临床的较佳治疗方案。方法对门诊诊治的100例慢性乙型肝炎患者1年和5年的诊疗经过及疗效指标进行统计学分析,包括肝功能指标ALT复常率、HBVDNA转阴率、HBeA g转阴率及其血清学转换率和耐药复发率。计算药物单价、疗程费用、药物成本-效果及敏感度分析。结果恩替卡韦与聚乙二醇干扰素α-2a 均对慢性乙型病毒性肝炎的治疗有效,1年疗效分别为84%和36%,成本-效果比值分别为140.4元和1 680.0元,以恩替卡韦为基准,每增加一个效果单位则聚乙二醇干扰素α-2a 需要增加1 014.3元。5年疗效分别为80.0%和64.0%,成本-效果比值分别为748.3元和945.0元,以恩替卡韦为基准,每增加一个单位效果则聚乙二醇干扰素α-2a 需要增加38.8元。结论治疗慢性乙型肝炎1年以恩替卡韦有效率最高,成本-效果值最低,效果最佳。治疗观察到第5年2组间治疗方案的成本、成本-效果比及增量成本-效果比的差距已逐渐缩小。核苷类抗病毒药物短中期治疗成本效果较优,而聚乙二醇干扰素α-2a 的优点在于较短的有限疗程及较好的长远成本-效果性。
OBJECTIVE To find appropriate proposal by evaluating the short-term and long-term cost-effectiveness of Entecavir and Peg-IFNα-2a against chronic Hepatitis B. METHODS The treatment process and efficacy,including their therapeutic schedule,serum ALT normalization,reductions in serum HBV DNA level,HBe Ag loss and seroconversion and the rate of drug resistance,of 100 patients with chronic hepatitis B who were treated after one year and five years in our outpatient clinic were reviewed. Not only the cost of the medicines and treatment process was calculated,but also the medicine cost-efficacy and sensitivity were analysed. RESULTS Both two kinds of drug therapy were effective for the treatment of CHB. The treatment efficacy of Entecavir and Peg-IFNα-2a were 84%and 36% respectively for one year. The ratio of cost-effectiveness were 140.4 CNY( Chinese Yuan) and 1 680.0 CNY. As a benchmark to entecavir,each additional unit effect of Peg-IFNα-2a needs increased investment of 1 014.3 CNY. The treatment efficacy of Entecavir and Peg-IFNα-2a were 80.0% and 64.0% respectively for five years. The ratio of cost-effectiveness were 748.3 CNY and 945.0 CNY.As a benchmark to entecavir,each additional unit effect of Peg-IFNα-2a need increased investment of 38. 8 CNY. CONCLUSION Among the two therapy,Entecavir has the better efficiency,lower potency of C / E values,the better cost-effectiveness in one year treatment of chronic hepatitis B. However,in the cost,ΔC / ΔE and C / E,the difference had been gradually narrowed between Entecavir and Peg-IFNα-2a until the 5th year. In conclusion,Entercavir has better cost-effectiveness in short-term and mid-term treatment. The benefit of Peg-IFNα-2a is limited short courses and better long-term cost-effectiveness.

关键词(KeyWords): 慢性乙型肝炎;恩替卡韦;聚乙二醇干扰素ɑ-2a;成本-效果;分析
chronic hepatitis B;entercavir;Peg-IFNα-2a ;cost-effectiveness;analysis

Abstract:

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基金项目(Foundation): 广东省医学科研基金(A2012260);; 广东省药学会科学研究基金(2013GRS02)

作者(Author): 廖云珍;叶晓光;周俊;
LIAO Yunzhen;YE Xiaoguang;ZHOU Jun;Department of Infectious Diseases,the Second Affiliated Hospital of Guangzhou Medical College;

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