3种用药方案治疗2型糖尿病的最小成本分析

Cost-Minimization Analysis of Three Drug Regimens in the Treatment of Type 2 Diabetes Mellitus

目的:比较3种用药方案治疗2型糖尿病的经济效益。方法:2型糖尿病患者住院病历中遴选出诺和胰岛素联合其中一种口服降糖药90份,用药方案分别为诺和胰岛素+阿卡波糖(A组)、诺和胰岛素+二甲双胍(B组)、诺和胰岛素+瑞格列奈(C组),比较3组疗效,并进行最小成本分析。结果:A、B、C组住院时间分别为(10.75±1.68)、(10.12±1.44)、(10.58±1.87)d,降低空腹血糖的有效率分别为76.74%、77.78%、75.00%(P>0.05),降低餐后2h血糖的有效率分别为67.44%、62.96%、65.00%(P>0.05),药物成本分别为(162.22±62.02)、(78.30±39.01)、(130.24±47.78)元,总成本分别为(2203.81±335.63)、(1869.77±202.16)、(2174.35±359.28)元。结论:B组用药方案治疗2型糖尿病经济性价比最高。

OBJECTIVE： To evaluate the economic returns among three drug regimens in the treatment of type 2 diabetes. METHODS： The medical records of 90 patients with type 2 diabetes mellitus （T2DM） treated with Novo insulin in combination with one kind of oral antidiabetic drug were reviewed： Novo insulin plus Acarbose（Group A）, Novo insulin plus Metformin （Group B） or Novo insulin plus Repaglinide（Group C） . The curative efficacy was compared among the three groups and a cost-minimization analysis was performed. RESULTS： In Group A, B and C, the lengths of hospital stay were （10.75± 1.68） days, （10.12 ± 1.44） days and （10.58 ± 1.87） days, respectively; the effective rates in lowering total fasting blood glucose were 76.74% , 77.78% and 75.00% （P〉 0.05）, and the effective rates in lowering postprandial blood glucose were 67.44%, 62.96% and 65.00%, respeetively（P 〉 0.05）; the drug costs were（162.22± 62.02）yuan, （78.30± 39.01） yuan and （130.24± 47.78） yuan, respectively, and the total cost were（2 203.81 ± 335.63）, （1 869.77± 202.16） and（2 174.35± 359.28） yuan, respectively. CONCLUSION： Group B had higher performance to price ratio among the three regimens for the treatment of type 2 diabetes.