摘要
目的 研究应用干扰素α2b(IFNα2b)治疗慢性乙型肝炎( 慢乙肝) 和慢性丙型肝炎( 慢丙肝)的长期经济学效果和效益。方法 根据全国12 个教学医院提供的6500 例慢乙肝资料,分成二个队列,其中2954 例为IFN 治疗组(乙型2198 例,丙型756 例);3 546 例为非IFN治疗组(乙型2 642 例,丙型904 例) 。同时应用MEDLINE和中国生物医学光盘文献数据库(CBMD) 检索有关慢乙肝、慢丙肝自然病程、转归和IFN 治疗效果的资料进行分析。所有数据应用决策分析软件,在微电脑上用Markov 模型模拟分析。结果 慢乙肝和慢丙肝治疗后,30 年内发展为代偿性、非代偿性和原发性肝细胞癌的转化率显著降低( P<0 .05)。在30 年内,慢乙肝和慢丙肝分别多存活5.32 年和4.06 年,生命质量调整年增加5 .41 年和4.27 年。为增加一个生命质量调整年贴现前分别节约5 180 和9 066 元人民币,贴现后节约2 509 和3722 元。30 年内应用IFN 总的直接医疗费用节约,慢乙肝贴现前为42 820 元,贴现后为25097 元;慢丙肝贴现前为65440 元,贴现后为33 382 元。结论 对于有适应证的慢乙肝和慢?
Objective The aim of this study is to evaluate the long term economic impact and benefit of treatment of chronic hepatitis B and C with interferon α 2b. Methods Data of 6?500 patients with chronic hepatitis B and C from 12 teaching hospitals in different areas of China were collected and analyzed. Cohorts of these patients with either chronic hepatitis B (2?198 cases) or chronic hepatitis C (756 cases) treated with IFNα 2b were compared with a non IFN treated cohort (B 2?642 and C 904 cases). Data sources regarding natural history, progression, efficacy and costs of IFN therapy from MEDLINE and Chinese Bio Medical Database (CBMD) search were also included. Using a decision analysis software program, Markov computer simulation was performed to estimate the progression of disease and economic analysis. Results The 30 years disease progression to compensated and uncompensated cirrhosis, hepatocellular carcinoma both in chronic hepatitis B and C in IFN treated cohort were significantly decreased in comparison with non IFN treated cohort. The results suggested that IFN treatment could increase life expectancy by 5.32 years in chronic hepatitis B and 4.06 years in chronic hepatitis C, respectively. In IFN treated group, the quality adjusted life years would increase by 5.41 and 4.27 years. The cost to improve the quality adjusted life per year could save 5?180 Yuan RMB or 9 066 Yuan RMB in either chronic B or C patients treated with IFN α2b. Within a 30 years period, the total direct medical costs will be saved 42?820 Yuan RMB and 65 440 Yuan RMB in chronic hepatitis B and C patients treated with IFNα 2b. Conclusion IFNα 2b therapy can prolong the life expectancy, quality of life and lower the medical costs for patients with chronic hepatitis B and C.
出处
《中华消化杂志》
CAS
CSCD
北大核心
1999年第6期369-374,共6页
Chinese Journal of Digestion