3种核苷类似物治疗慢性乙型肝炎的成本-效果分析

Cost-effectiveness analysis of three kinds of nucleoside analogues for chronic hepatitis B

目的探讨3种核苷类似物治疗慢性乙型肝炎的经济效果。方法将268例患者分成3组,ADV组用阿德福韦酯10 mg,ETV组用恩替卡韦0.5 mg,LdT组用替比夫定600 mg,均为每天1次,疗程均为48周。进行疗效和不良反应观察,应用药物经济学成本-效果分析法进行评价。结果在HBV-DNA阴转率方面,ETV组和LdI组好于ADV组(P<0.01);在HBeAg阴转率和ALT复常率方面,3组差异无显著性(P>0.05);3组的不良反应差异无显著性(P>0.05);经济学方面,ADV组、ETV组、LdT组的成本-效果比分别是115.38、156.51、96.98,替比夫定优于阿德福韦酯和恩替卡韦。结论替比夫定组为优选方案。

Objective To investigate economic effects of three kinds of nucleoside analogues in treatment of chronic hepatitis B. Methods 268 cases were divided into three groups, ADV group with adefovir dipivoxil 10rag, ETV group with entecavir 0.5 mg, LdT group with telbivudine 600 mg. All the groups were administered once a day with a course of 48 weeks. Efficacy and adverse reactions were observed. Cost-effectiveness analysis was used. Results ETV group and LdT group were better than ADV group in terms of HBV-DNA negative conversion rate（ P 〈 0.01 ） ,in HBeAg negative conversion rate and ALT normalization rate, three groups showed no statistically significant differences（P 〉 0.05 ）, The adverse reactions of three groups had no significant difference（ P 〉 0.05 ）. The ef- fectiveness ratio of ADV group, ETV group, LdT group was 115.38, 156.51, 96.98 respectively. Telbivudine was superior to adefovir dipivoxil and entecavir in terms of economics. Conclution Telbivudine group was the optimal solution for chronic hepatitis B.