恩替卡韦与阿德福韦酯对慢性乙型肝炎的成本-效果分析

Cost-effectiveness analysis of different drugs in patients with chronic hepatitis B

目的分析恩替卡韦与阿德福韦酯对慢性乙型肝炎的成本-效果。方法将84例慢性乙型肝炎患者随机分为恩替卡韦组40例和阿德福韦酯组44例治疗,两组均治疗观察12个月。运用药物经济学方法分析其成本-效果(C/E)。结果治疗3个月恩替卡韦组丙氨酸氨基转移酶(ALT)复常率明显高于阿德福韦酯组,差异有统计学意义(P<0.05);治疗6、12个月两组ALT复常率无明显差异。治疗3、6、12个月恩替卡韦组乙型肝炎病毒(HBV)-DNA转阴率均明显高于阿德福韦酯组,差异有统计学意义(P<0.05)。治疗3、6、12个月恩替卡韦组乙型肝炎E抗原(HBeAg)转阴率均明显高于阿德福韦酯组,差异有统计学意义(P<0.05)。治疗12个月恩替卡韦组的ALT复常率、HBV-DNA转阴率、HBeAg转阴率的C/E分别为273.3、352.6、911.0,阿德福韦酯组分别为194.2、328.6、908.6。将阿德福韦酯组作为参照,恩替卡韦组HBV-DNA转阴率及HBeAg转阴率的增量成本-效果(△C/△E)分别为129.7、182.1。结论从短期看,阿德福韦酯治疗慢性乙型肝炎的疗效尚可,药物经济学价值较高,而恩替卡韦虽然疗效更好,但疗效与成本尚未达到理想的平衡。

Objective To analysis the cost-effectiveness analysis of different drugs in patients with chronic hepatitis B.Methods 84 patients with chronic hepatitis B were randomly divided into Entecavir(ETV)group with 40 cases and Adefovir dipivoxil(ADV)group with 44 cases,and pharmacoeconomic analysis of cost effectiveness(C/E)were conducted.Results ALT complex rate,HBVDNA negative rate and HBeAg negative rate after 12 months treatment of the ETV group were 100.0%,77.5% and 30.0%,and of the ADV group were 100.0%,59.1% and 13.6%,the HBV-DNA negative rate and HBeAg negative rate between the two groups were statistical significant(P<0.05).The C/E of ALT complex rate,HBV-DNA negative rate and HBeAg negative rate of the ETV group were 273.3,352.6 and 911.0,and of the ADV group were 194.2,328.6 and 908.6.ADV group as a reference,the △C/△E of HBV-DNA negative rate and HBeAg negative rate of the ETV group were 129.7 and 182.1.Conclusions In the short term,Adefovir dipivoxil in the treatment of chronic hepatitis B is acceptable,the value of pharmacoeconomics is high,but whether it is the ideal long-term antiviral program remains to be studied.