2种用药方案治疗慢性丙型肝炎的药物经济学评价

Pharmacoeconomic Evaluation of 2 Therapeutic Schemes for Chronic Hepatitis C

目的:评价2种用药方案治疗慢性丙型肝炎(CHC)的经济学效果。方法:185例CHC患者按照治疗方案的不同分为长效组(聚乙二醇干扰素α-2a联合利巴韦林)与普通组(普通干扰素α-2a联合利巴韦林),针对不同基因型分别采用最小成本分析法和成本-效果分析法进行研究,效果指标采用持续病毒学应答率(SVR),成本指标采用直接医疗服务成本。结果:对于基因2型、3型的CHC患者,长效组与普通组的SVR分别为76.5%、63.5%(P>0.05),治疗成本分别为30235.20、36950.40元(P<0.05);对于基因1型、未分型的CHC患者,长效组与普通组的SVR分别为52.9%、25.8%(P<0.05),成本-效果比分别为114310.77、143218.60,长效组相对于普通组的增量成本-效果比为86789.67。结论:从药物经济学角度看,聚乙二醇干扰素α-2a联合利巴韦林治疗CHC优于普通干扰素α-2a联合利巴韦林方案。

OBJECTIVE： To evaluate the pharmacoeconomic efficacy of PEGIFNα-2a/RBV versus IFNα-2a/RBV in the treatment of chronic hepatitis C（CHC）. METHODS： 185 patients with chronic hepatitis C were assigned to either prolonged action group （PEGIFNα-2a＋ribavirin） or common group （IFNα-2a＋ribavirin）. Cost-minimization analysis and cost-effectiveness analysis were adopted respectively to study the different HCV genotype cases. The effectiveness was measured with the sustained virological response （SVR） as index, and the direct healthcare cost served as the cost index. RESULTS： For CHC patients with HCV 2 or HCV 3 genotype, the SVR of PEGIFNα-2a/RBV group was 76.5% as compared with 63.5% of IFNα-2a/RBV group （P0.05）, and the treatment costs of the two groups were 30 235.20 yuan and 36 950.40 yuan, respectively （P0.05）. For patients with HCV 1 genotype or those without genotyping, the SVR of PEGIFNα-2a /RBV group and IFNα-2a/RBV group were 52.9% and 25.8%, respectively （P0.05）, and the cost-effectiveness ratios were 114 310.77 and 143 218.60, respectively; and the incremental cost-effectiveness ratio of the prolonged-action group was 86 789.67 as against the common group. CONCLUSION： In terms of pharmacoeconomics, PEGIFNα-2a/RBV scheme is superior to IFNα-2a /RBV scheme in the treatment of chronic hepatitis C.