α-2b干扰素治疗慢性丙型肝炎的经济学评价

Economic appraisal of interferon alfa-2b treatment of chronic hepatitis C

目的:对上海、北京和石家庄三城市应用α-2b干扰素治疗慢性丙型肝炎做经济学评价.方法:根据对三城市的部分慢性丙肝、代偿性肝硬化、失代偿性肝硬化病人调查所得的门诊费用、住院费用.并根据慢性丙型肝炎的自然史和α-2b干扰素的治疗效果,预测并比较α-2b干扰素治疗组和常规治疗组的慢性丙肝病人在30a内的有关费用和预后,并进行成本-效益和成本-效果分析.结果:治疗后30a内,α-2b干扰素治疗组比常规治疗组增加852个存活人年和1487个生命质量调整年.α-2b干扰素治疗组比常规治疗组节省医疗费用29459371元,效益-成本比值为1.32.α-2b干扰素治疗组比常规治疗组每增加一个生命年所节省的费用为8321元,每增加一个生命质量调整年所节省的费用为4768元.结论:应用α-2b干扰素治疗慢性丙型肝炎可取得较好的临床和经济学结果.

AIM: To appraise the medical and economic significance of treating chronic hepatitis C with interferon alfa-2b in Shanghai,Beijing and Shijiazhuang in China. METH-ODS: Based on the retrospective data of direct medical costs of caring for patients with chron-ic hepatitis C,compensated cirrhosis and decompensated cirrhosis collected from several hos-pitals of Shanghai , Beijing and Shijiazhuang, 2 hypothetical cohorts, with or without inter-feron alfa-2b treatment, each consisted of 1000 patients. They were compared for projected clinical and economic outcomes over 30 year period. RESULTS: Compared with the cohort untreated with interferon alfa-2b,71 lifeloss were prevented ,852 life-years and 1 487 quality-adjusted-life-years (QALYs) are accrued and 29459371 yuan are saved in the treated cohort. The cost-effectiveness ratio is 1. 32. Compared to the untreated cohort,99907 yuan per lifer saving,8321 yuan per life-year saving and 4768 yuan per QALYs saving were accrued in the treated cohort. CONCLUSION : The interferon alfa-2b treatment of chronic hepatitis C in Shanghai,Beijing and Shijiazhuang has good clinical and economic outcomes.