两种非甾体抗炎药物方案治疗类风湿关节炎的成本—效用分析

Cost-utility Analysis of Two Nonsteroidal Antiinflammatory Drugs Therapeutic Schemes for Rheumatoid Arthritis.

目的 :评价两种非甾体抗炎药物的疗效和经济性 ,探索成本 -效用分析方法的应用。方法 :对 1 0 6例类风湿关节炎 (RA)患者随机分两组 (A:奥湿克组 ,B:扶他林组 ) ,使用自编 RA生命质量量表对患者进行评价 ,提取评分法效用值 ,进行成本效用分析 (cost- utility analysis,CUA)。结果 :B组的成本效用比 (CUR)为 52 92 7.0 8元 / QALY,A组的 CUR值 67838.30元 / QALY,敏感度分析得到一致结果 ,增量成本效用分析表明每增加 1 QALY,A组至少需追加花费1 9980 5.1 4元 ,故认为 B方案经济、有效。结论 :对于 RA、癌症等慢性病患者采用 CUA分析 ,能够全面评价患者生命质量 。

Objective To evaluate the economic effectiveness in different pharmacotherapeutic schemes of nonsteroidal antiinflammatory drugs(NSAIDs)for rheumatoid arthritis(RA)and explore the methodological of cost utility analysis(CUA).Methods:106 outpatients with RA were selected prospectively.These patients were randomly divided into two groups which received different therapeutic schemes(A:arthrotec,B:votalin).Quality of life were measured with self administered instrument of RA(QOL RA)at baseline and every one month.Utility scores were obtained so as to conduct CUA.Results:After 12 weeks follow up,average cost per quality adjusted life year(QALY)for group B was 52927.08 yuan(RMB),and group A was 67838.30 yuan (RMB)respectively.Sensitivity analysis also were similar results.Incremental cost analysis show that extra cost per QALY gained by group A was 199805.14 yuan(RMB).Conclusion:Base on this study,B scheme may be cost saving for RA patients.CUA is a valuable source of information which has resource implications for the health services,especially for chronic diseases such as RA and cancer patients.