今日药学

2012, v.22(05) 260-263

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4种核苷类药物治疗慢性乙型肝炎2年的成本-效果分析
Cost-Effectiveness Analysis of 4 Kinds of Nucleoside Treatment for Chronic Hepatitis B in 2 Years

宋玲英;叶晓光;
SONG Ling-ying,YE Xiao-guang(Department of Infectious Diseases,the Second Affiliated Hospital of Guangzhou Medical College, Guangzhou,Guangdong 510260,China)

摘要(Abstract):

目的对拉米夫定、阿德福韦酯、替比夫定和恩替卡韦4种药物治疗慢性乙型肝炎2年作成本-效果分析,找出适合临床的最佳治疗方案。方法对本科门诊诊治的200例慢性乙型肝炎患者的2年诊疗经过和疗效进行统计,包括肝功能指标ALT复常率、HBVD-NA转阴率、HBeAg转阴率及其血清学转换率和耐药率。计算药物单价、疗程费用、药物成本-效果及敏感度分析。结果这4种药物拉米夫定、阿德福韦酯、替比夫定和恩替卡韦均对治疗慢性乙型病毒性肝炎有效,疗效分别为7.8%,3.2%,35.8%和86%。成本-效果比值分别为1379.99元、4 129.12元、460.55元和308.73元。以恩替卡韦为基准,每增加一个效果单位拉米夫定、阿德福韦酯、替比夫定分别需要增加201.88元,161.08元,200.47元。结论治疗慢性乙型肝炎2年以恩替卡韦有效率最高,成本-效果值最低,效果最佳。
Objective To evaluate the cost-effectiveness of 4 nucleosides(lamivudine,adefovir,telbivudine,and entecavirr) against chronic Hepatitis B and to find appropriate proposal.Methods The efficacy and cost of 200 patients who were treated over 2 years with chronic hepatitis B in our outpatient were calculated,including their serum ALT normalization,reductions in serum HBV DNA level,HBeAg loss and seroconversion and the rate of drug resistance.The cost of lamivudine,adefovir,telbivudine entecavir and cost-effectiveness was calculated.Results The four medicine all had better effective.Efficacy of lamivudine,adefovir dipivoxil,telbivudine and entecavir treatment were 7.8%,3.2%,35.8%,and 86%,respectively.The ratio of cost-effectiveness were 1 379.99,4 129.12,460.55,and 308.73 Yuan.As a benchmark to entecavir,each additional unit of effect of lamivudine,adefovir dipivoxil,telbivudine,need increased investment of 201.88,161.08,200.47 RMB,respectively.Conclusion Among the 4 medicine,Entecavir has the highest efficiency,lowest potency of C/E values,the best of cost-effectiveness in 2-years treatment of chronic hepatitis B.

关键词(KeyWords): 慢性乙型肝炎;成本-效果;治疗;核苷类药物
chronic hepatitis B;cost-effectiveness analysis;treatment;nucleoside

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基金项目(Foundation): 广东省药学会肝炎用药研究基金项目(编号:2011G29)

作者(Author): 宋玲英;叶晓光;
SONG Ling-ying,YE Xiao-guang(Department of Infectious Diseases,the Second Affiliated Hospital of Guangzhou Medical College, Guangzhou,Guangdong 510260,China)

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