阿奇霉素对比阿莫西林/克拉维酸治疗下呼吸道感染的药物经济学评价

Pharmacoeconomics Evaluation of Azithromycin vs. Amoxicillin Clavulanate in the Treatment of Lower Respiratory Tract Infection

目的:评价阿奇霉素对比阿莫西林/克拉维酸治疗下呼吸道感染的经济性。方法:首先采用系统评价的方法,检索并筛选阿奇霉素(试验组)对比阿莫西林/克拉维酸(对照组)治疗下呼吸道感染的随机对照试验(RCT),提取资料并进行Meta分析。在此基础上,增加成本因素,再基于短期决策树模型,采用Treeage Pro 2011版软件,依据受试对象、干预措施、重要结局和设计方案(PICO原则)进行经济学评价。结果:共纳入18项RCT,合计3 365例患者。两组患者治疗有效率[RR=0.93,95%CI(0.55,1.55),P=0.77]和不良反应发生率[RR=0.79,95%CI(0.62,1.0),P=0.05]比较差异均无统计学意义。成本方面,试验组的平均治疗费用为790.4元,成本-效果比为216.0;对照组的平均治疗费用为884.4元,成本-效果比为245.7;增量成本-效果比为-1 392.59。结论:阿奇霉素治疗下呼吸道感染的疗效和安全性与阿莫西林/克拉维酸相当,但阿奇霉素具有较好的成本-效果比。

OBJECTIVE：To evaluate the economics of azithromycin vs. amocillin clavulante in the treatment of lower respiratory tract infections. METHODS：System evaluation was adopted to retrieve the randomized controlled trials（RCT）about azithromycin（test group）vs. amoxicillin clavulanate（control group）in the treatment of lower respiratory tract infections. Information was collected and Meta-analyses were performed. On this basis and short-term decision tree model,cost factors were added to conduct the pharmacoeconomics by the principle of PICO of Treeage Pro 2011 edition software. RESULTS：Totally 18 RCT were enrolled,involving 3 365 patients. Results of Meta-analysis showed that there were no significant differences in the effective rate [RR=0.93,95%CI（0.55,1.55）,P=0.77] and incidence of adverse reactions [RR=0.79,95%CI（0.62,1.0）,P=0.05] between 2 groups. The average treatment cost in test group and control group was respectively 790.4 yuan and 884.4 yuan,and cost-effectiveness ratio was respectively 216.0 and 245.7,and the incremental cost-effectiveness ratio（ICER）was-1 392.59. CONCLUSIONS：Azithromycin has similar efficacy and safety to amoxicillin clavulanate in the treatment of lower respiratory tract infection,however,azithromycin has better cost-effectiveness.