厄他培南对比哌拉西林/他唑巴坦治疗复杂性腹腔感染的成本效果-分析

The Cost-effectiveness Analysis of Ertapenem vs. Piperacillin/tazobactam in Patients with Complicated Intra-abdominal Infections

目的:为了解厄他培南与哌拉西林/他唑巴坦治疗复杂性腹腔感染(c IAI)的经济性,为临床合理用药提供参考。方法:构建决策树模型对厄他培南治疗复杂性腹腔感染进行成本-效果分析,疾病治疗情况和治疗费用,临床试验中药物的治疗有效性和中国的耐药菌的药物敏感度情况等参数主要来源于相关临床试验和文献。针对参数的不确定性进行敏感性分析。结果:厄他培南与哌拉西林/他唑巴坦相比有效率略高,单次住院厄他培南较哌拉西林/他唑巴坦可节约2566元,多治愈1位c IAI患者可节约卫生费用33966元。敏感性分析显示厄他培南和哌拉西林/他唑巴坦的疗效会对结果产生较大影响,其他因素对结果影响不大,上述结论相对稳健。结论:厄他培南在治疗复杂性腹腔感染与哌拉西林/他唑巴坦相比是成本节约的,即厄他培南治疗复杂性腹腔感染具有经济性。

Objective： The objective of this study was to evaluate the cost-effectiveness of ertapenem vs. piperacillin/tazobactam in complicated intra-abdominal infections （cIAI） patients and to provide clinicians with some advice. Methods： A decision tree model was built to evaluate the cost effectiveness of ertapenem vs. piperacillin/tazobactam in cIAI patients. The data of efficacy, cost, sensitivity of drug resistant bacteria in China and other key parameters are from clinical randomized trials and literatures. The parameters uncertainty in the model was estimated through sensitivity analysis. Results： In the basecase analysis, the effectiveness of ertapenem was high than piperacillin/tazobactam, and ertapenem can save 2,566 yuan in a single hospitalization. Ertapenem cure one patient can save 33,966 yuan. The sensitive analysis show that the efficacy of ertapenem and piperacillin/tazobactam has great influence to results, other factors have little effect on the results. Conclusion： Compared with piperacillin/tazobactam, ertapenem was cost-saving in cIAI patients, so ertapenem was more cost-effectiveness.