枸橼酸铋钾、克拉霉素和替硝唑治疗消化性溃疡的药物经济学评价

Pharmacoeconomic evaluation of bismuth potassium citrate plus clarithromycin and tinidazole in treatment of digestive ulcer

目的 :比较 4个不同三联药物治疗消化性溃疡方案的成本效果分析。方法 :3 1 1例消化性溃疡病人 ,分 5组 ,运用药物经济学的最小成本法、成本效果分析法进行推算每例诊疗成本和评价。结果 :(1 )A ,B ,C ,D 4种三联治疗方案的幽门螺杆菌(Hp)根除率分别为 84% ,88% ,87% ,80 % ,各组间疗效相比P >0 .0 5 ;(2 )门诊诊疗总成本分别为5 86元 ,81 7元 ,648.2 7元 ,889.5 0元 ;(3 )应用枸橼酸铋钾 +克拉霉素 +替硝唑 (BCT)三联治疗 1wk溃疡愈合 1例的药费 3 0 3 .95元 ;Hp根除 1例的药费 2 75 .0 0元 ;(4 )BCT三联包装比单独包装 3种药物 ,每例病例可节约药费 47.3 7元。结论 :4种方案的成本效果分析和边际成本分析表明BCT三联治疗 1wk的门诊诊疗成本最低 ,为根除Hp的优选方案。

AIM: To compare the cost effectiveness of four kinds of triad treatment of peptic ulcer. METHODS: Three hundred and eleven patients with peptic ulcer were divided into five groups. The cost and effectiveness of every patient was calculated with pharmaco economic evaluation and cost effectiveness analysis. RESULTS: (1) There was no significant statistic difference( P >0.05) between groups. The eradication rate of Hp was 84 % in BCT A group(bismuth potassium citrate plus clarithromycin and tinidazole, BCT A), 88 % in BCT B group, 87 % in control group C(omeprazole, metronidazole and amoxicillin), 80 % in control group D(omeprazole, clarithromycin and tinidazole). (2) But its out patient clinical cost was 586 RMB per patient in BCT A, 817 RMB in BCT B, 648.27 RMB in control group C and 889.5 RMB in control group D. (3) The pharmaceutical cost of peptic ulcer healing with the BCT A was 303.95 RMB per patient, and its cost of Hp eradication was 275 RMB per patient. (4) 47.37 RMB per patient could be saved with the BCT, instead of respective packs of three drugs. CONCLUSION: The cost effectiveness analysis and marginal cost analysis indicate that BCT A is one of optimized therapeutics for eradication of Hp , since its outpatient cost is lowest.