干扰素治疗慢性乙型肝炎患者的成本效果分析

Cost-effectiveness analysis of treatment of chronic hepatitis B with interferon in chinese city

目的研究干扰素（ＩＦＮ）用于中国城市慢性乙型肝炎患者治疗的经济学意义。方法根据Ｍａｒｋｏｖ理论、以常规治疗为对照，用寿命表法推算干扰素治疗后３０年内每延长一个人年或增加一个生命质量调整年（Ｑｕａｌｉｔｙａｄｊｕｓｔｅｄｌｉｆｅｙｅａｒ，ＱＡＬＹ）的医疗费用。用敏感度分析检验结论的稳定性。结果ＩＦＮ治疗每延长一个人年和每增加一个ＱＡＬＹ的费用不超过２３５９元和１７７５元；而在有些城市这种治疗可以达到节约医疗费用的目的。结论ＩＦＮ治疗慢性乙型肝炎具有良好的成本效果比值，在卫生资源的调配中应考虑该药的合理使用。

Objective In this article, we evaluated the economic significance of treationg HBeAg-positive chronic hepatits B with interferon in Chinese population. Methods Cohoft of 1 000 hypotheticalHBeAg-positive chronic hepatitis B pantients treated with interferon was compared to patients with routinetreatment in respeCt of cost and effectiveness. The costs of routine treatment were estimated by'surveys infour Chinese cities (Beijing, Shanghai, Nanning and Shijiazhuang). Natural history of HBeAg-positivechronic hepatitis B and the efficacy of interferon were determined by meta-analysis. Outcome of thedisease and medical cost of the two cohorts were predicted over a period of 30 years using survivalanalysis. Thus, cost per life year and cost per QALY(Quality adjusted life year) with the interferontreatment were calculated. Sensitivity analysis was performed to tact the firmness of the conclusion. Results Costs per life year and per QALY saved were no more than 2359 Yuan(RMB) and 1775 Yuan(RMB) resistively. In Shanghai and Beijing, medical costs could be saved due to the use of interferon.Conclusions Treatment of chronic hepatitis B with interferon was cost-effective and should be consideredin the allocation of health resource in Chinese cities.