住院糖尿病患者使用甘精胰岛素和NPH控制血糖达标的最小成本分析

A cost-minimization analysis of giargine and NPH in inpatient management of diabetes mellitus

目的比较住院患者使用甘精胰岛素(glargine)和中性鱼精蛋白锌胰岛素(NPH)控制血糖达标的成本。方法92例新诊断的2型糖尿病患者,70例用口服降糖药治疗的2型糖尿病患者以及16例1型糖尿病患者进入本研究,每组等分为两亚组,分别予glargine和NPH,运用药物经济学最小成本分析法比较两种药物的治疗成本。结果3组研究人群均显示,与NPH比较,glargine单药成本(人民币元)高(116．30±18．80 vs 38．68±6．57,190．84±30．37vs53．43±7．15,120．06±10．90 vs 29．51±2．17),每日成本(人民币元)高(431．62±62．18vs 370．16±49．80,356．48±55．46 vs 335．77±41．69,294．12±55．99vs 245．17±29．57),总成本(人民币元)低(2 679．40±92．49 vs 3016．50±174．72,3 629．23±105．55vs 3 821．62±140．25,1 576．55±114．69vs 1 715．85±126．32)。结论使用glargine控制血糖较NPH节约住院成本。

Objective To compare the administration cost of glargine and neutral protamine hagedorn （NPH） in glycemic control. Methods Ninty-two patients with newly diagnosed type 2 diabetes mellitus （DM） （G1）, 70 patients with type 2 DM inadequately controlled by oral glucose-lowering agents （G2） and 16 patients with type 1 DM （ G3 ） were selected. Each group was divided into 2 subgroups treated with glargine or NPH. Costminimization analysis was applied to analyze the costs. Results Expense （RMB Yuan） on glargine was more than that onNPH （116.30 ±18.80 vs38.68±6.57, 190.84 ±30.37vs53.43±7.15, 120.06 ±10.90vs29.51± 2.17 in G1, G2 and G3 respectively） , mean cost （RMB Yuan） per patient per day with glargine was greater than that on NPH（431.62 ± 62.18 vs 370. 16 ± 49.80,356.48 ± 55.46 vs 335.77 ± 41.69, and 294. 12 ± 55.99 vs 245.17 ±29.57 in G1, G2 and G3 respectively） , while the total cost （RMB Yuan） per admission for the patients receiving glargine was less than NPH （ 2 679.40 ± 92.49 vs 3 016.50 ± 174.72,3 629.23 ± 105.55 vs 3 821.62 ± 140.25,1 576.55 ± 114.69 vs 1 715.85 ± 126. 32 in G1, G2 and G3 respectively）. Conclusion This study shows that in patients receiving glargine there are direct medical cost savings, which compensats for the higher price of this kind of insulin.