3种质子泵抑制剂治疗消化性溃疡的最小成本分析

Cost-minimization Analysis of 3 Kinds of PPIs in the Treatment of Peptic Ulcer

目的:比较雷贝拉唑、泮托拉唑和奥美拉唑治疗消化性溃疡的经济性。方法:选取我院2015年1-10月收治的消化性溃疡患者189例,按随机数字表法分为雷贝拉唑组(A组)、泮托拉唑组(B组)和奥美拉唑组(C组),各63例。3组患者均根据病情按照药品说明书方法治疗4周,计算临床有效率、幽门螺杆菌(Hp)清除率和不良反应发生率,并进行经济学评价。结果:A、B、C组患者的有效率分别为79.4%、81.0%、77.8%,Hp清除率分别为85.7%、85.7%、83.7%,不良反应发生率分别为11.1%、12.7%、12.7%,差异均无统计学意义(P>0.05),故采用最小成本分析法进行经济学评价。A、B、C组患者的成本分别为704.08、648.92、611.96元,A组>B组>C组;敏感性分析支持该结果。结论:雷贝拉唑、泮托拉唑和奥美拉唑治疗消化性溃疡的疗效和安全性均较好,但相较于雷贝拉唑和泮托拉唑,奥美拉唑治疗消化性溃疡的成本更低、经济性更好,临床可根据患者实际情况选择用药。

OBJECTIVE： To compare the economy of rabeprazole, pantoprazole and omeprazole in the treatment of peptic ulcer. METHODS： 189 patients with peptic ulcer admitted into our hospital during Jan.-Oct. in 2015 were divided into rabeprazole group （group A）, pantoprazole group （group B） and omeprazole group （group C） according to random number table, with 63 cases in each group. 3 groups received treatment for 4 weeks according to package inserts based on disease condition. Clinical effective rate, Hp clearance rate and the incidence of ADR were calculated, and the economy was evaluated. RESULTS： The effective rates of groups A, B and C were 79.4%, 81.0% and 77.8% ; Hp clearance rates were 85.7%, 85.7% and 83.7% ; the incidence of ADR were 11.1%, 12,7% and 12.7%, without statistical significance （P〉0.05）, So cost-minimization analysis was used for economic evaluation. The costs of groups A, B and C were 704.08, 648.92, 611.96 yuan, and the descending order group A〉group B〉group C. Sensitivity analysis supported the result. CONCLUSIONS： Rabeprazole, pantoprazole and omeprazole show good therapy efficacy and safety in the treatment of peptic ulcer. Compared to rabeprazole and pantoprazole, omeprazole has lower cost and better economics in the treatment of peptic ulcer. The drugs should be chosen according to disease condition.