噻托溴铵与异丙托溴铵在慢性阻塞性肺疾病治疗中的成本-效果评价分析

Cost-effectiveness analysis of tiotropium bromide and ipratropium bromide in patients with COPD

目的:开展对噻托溴铵与异丙托溴铵在临床治疗慢性阻塞性肺疾病(COPD)患者的药物经济学研究,为临床用药决策提供依据。方法:采用回顾性研究筛选某院COPD患者,建立马尔可夫(Markov)模型对接受噻托溴铵与异丙托溴铵的患者进行模拟,并参考相关随机对照试验研究成果以及中外公开发表的文献。结果:5年噻托溴铵组和异丙托溴铵组的效果值质量调整生命年(QALYs)分别为3.90和3.87,噻托溴胺组成本为5 792.55元,比对照组减少1 262.9元,增量成本-效果比为119 977.67元/QALY。结论:在治疗COPD过程中,5年内噻托溴铵组和异丙托溴铵组治疗方案疗效相当,但噻托溴铵组的成本更低,治疗更具有成本-效果性。

OBJECTIVE To develop cost-effectiveness analysis for tiotropium bromide （TB） and ipratropium bromide （i-TB） in COPD patients by using Markov model, which could be helpful for clinical staff to develop therapeutic regimen. METHODS Markov model was constructed to simulate development of healthy status of COPD patients in both TB and i-TB arms. Data were screened from Pneumology Department of our hospital by using retrospective method and randomized controlled trials （RCT） in publications. RESULTS Five-year cycle results showed that patients in TB and i-TB group were 3. 90 and 3. 87 QALYs, respectively, and ICER value was 119 977. 67 yuan/QALY. Cost of patients receiving TB was 5792. 55 yuan which was 1 262. 90 yuan less than that of i-TB. CONCLUSION There is no significant difference of curative effects between TB and i-TB groups. However, the cost of TB group is lower than that of i-TB group.