三种非甾体抗炎药治疗类风湿关节炎的成本-效果分析

A Cost-Effectiveness Analysis of Three NSAIDs in Treatment of rheumatoid arthritis

目的研究3种常用非甾体抗炎药(NSAID)治疗类风湿关节炎(RA)的经济效果和安全性。方法选择病情处于活动期的RA患者180例,随机分为A、B、C 3组,每组60例。A组选用布洛芬缓释胶囊;B组选用双氯芬酸缓释胶囊;C组选用美洛昔康片。基础用药与检查各组均相同。运用药物经济学的成本-效果分析方法对各组进行评价。结果3组方案治疗RA的成本平均每例分别为:A组(209.71±80.13)元,B组(291.36±100.89)元,C组(262.44±47.58)元;有效率依次为:66.7%、81.7%、76.7%;每获得一个单位效果,依次需花费成本3.14元、3.57元、3.42元;不良反应的发生率依次为:20.0%、33.3%、15.0%。在A方案的基础上,每获1个单位效果,方案B、C所花费的成本分别为:5.44元、5.27元。结论A方案成本最低,但有效率较低;B方案有效率最高,但不良反应发生率亦最常见。RA患者选用C方案为宜。

Objective To investigate the economic effect and safety of three nonsteroidal anti - inflammatory drugs （NSAIDs） in treatment of rheumatoid arthritis （RA）. Methods One hundred and eighty patients with RA at active stage were randomly divided into three groups： group A, B and C, each group was 60 cases. The patients of group A, B and C were given Ibuprofen Sustained Release Capsules, Dielofenae Sustained - release Capsules and meloxieam tablets respectively. The obtained data were evaluated by the pharmacoeconomic cost - effectiveness analysis. Results The average costs of each patient in group A, B and C were 209.71 ± 80.13,291.36 ± 100.89 and 262.44 ± 47.58 yuans respectively. The effective rates of three groups were 66.7 %, 81.7 % and 76.7 %, respectively. The costs of three therapeutic regimen of A, B and C were 3.14,3.57 and 3.42 yuans,respectively for increasing 1% of effective rate. The incidence rate of adverse reaction in groups of A,B and C were 20. 0 %, 33.3 % and 15.0 %, respectively. On the foundation of A therapeutic regimen, the average costs of each patient in groups of B and C were 5.44 and 5.27 yuans respectively, for increasing 1% of effective rate. Conclusions Among three therapeutic regimens, the cost of regimen A was the lowest,but the effective rate was also the lowest. The effective rate of the regimen B was the highest, but the incidence rate of adverse reaction in groups of B was the highest too. So that, regimen C was a best regimen for common patients of RA.