沙利度胺与二丁酰环磷腺苷钙治疗老年重度寻常型银屑病的药物经济学评价

Pharmacoeconmic Evaluation of Thalidomide and Calcium Dibutyryladenosine Cyclophosphate in the Treatment of Elderly Severe Psoriasis Vulgaris

目的对沙利度胺与二丁酰环磷腺苷钙治疗老年重度寻常型银屑病进行药物经济学评价。方法通过医院信息系统(HIS)采集2016年10月1日-2018年5月31日大连市皮肤病医院老年重度寻常型银屑病患者的病历资料进行回顾性分析,比较接受沙利度胺与二丁酰环磷腺苷钙治疗老年重度寻常型银屑病的疗效和成本费用,并采用单因素敏感性分析结果的稳定性。结果沙利度胺组显效率为43.37%,二丁酰环磷腺苷钙组显效率为35.00%,差异无统计学差异;沙利度胺组3,6个月未再次入院风险率为86.75%和71.08%,二丁酰环磷腺苷钙组3,6个月未再次入院风险率为75.00%和57.00%,差异有统计学差异(P<0.05);沙利度胺组人均成本9999.86元,二丁酰环磷腺苷钙组人均成本9223.17元;以显效率为疗效指标,二丁酰环磷腺苷钙成本最低,以6个月未再次入院风险率为疗效指标沙利度胺具有最优经济性(ICER=5547.79),敏感性分析显示结果可靠。结论二丁酰环磷腺苷钙治疗老年重度寻常型银屑病近期疗效成本最低,而沙利度胺的远期疗效更具有成本效果优势。

OBJECTIVE To compare the pharmacoeconmic effect of thalidomide(THD)and calcium dibutyryladenosine cyclophosphate(CDC)in the treatment of elderly severe psoriasis vulgaris.METHODS The case data of patients with elderly severe psoriasis vulgaris in Dalian Dermatosis Hospital from October 1,2016 to May 31,2018 were collected through the HIS for a retrospective analysis,to compare the curative effects and costs of patients respectively accepting THD and CDC to treat the elderly severe psoriasis vulgaris,and then the single factor sensitivity analysis was conducted to check the stability of results.RESULTS The efficiencies of the group of patients treated with CDC and THD had no statistical difference(43.37%vs 35.00%),but the readmissions within 3 and 6 months of the THD group(86.75%&71.08%)were significantly higher than those of the CDC group(75.00%&57.00%),with statistical difference(P<0.05).The total cost of treatment of the THD group was 9999.86 yuan,and that of the CDC group was 9223.17 yuan.If taking the cost minimization analysis method and with marked effective rate as the index,the CDC group had better cost minimization;with the ratio of no recurrence within 6 months as the index,the THD group had the optimum economy(ICER=5547.79),with sensitivity analysis showed its reliability.CONCLUSION In terms of short term curative effect,the cost of CDC is lower in the treatment of elderly severe psoriasis vulgaris,while the THD enjoys cost-effectiveness advantage in long term curative effect.