药物治疗原发性精索静脉曲张型少精子症患者的成本-效用分析

Cost-Utility Analysis of Drug Treatment for Oligozoospermia of Primary Varicocele

目的探讨药物治疗原发性精索静脉曲张型少精子症患者的成本-效用。方法选取2019年1—6月于广东省计划生育专科医院男科门诊就诊的174例原发性精索静脉曲张型少精子症患者作为研究对象,按照治疗方式不同分为药物治疗组(观察组)96例和手术治疗组(对照组)78例,比较治疗3个月后两种方案的有效性、治疗成本和健康效用值,通过计算两种方案的质量调整生命年评估两组的成本-效用比值。结果治疗3个月后观察组的精液改善率为46.88%(45/96)低于对照组53.85%(42/78),但差异无统计学意义(χ2=0.837,P=0.446);观察组配偶妊娠率为6.25%(6/96)也低于对照组11.43%(8/70),但差异无统计学意义(χ2=0.934,P=0.406)。观察组健康效用值为(1.57±0.63)、质量调整生命年为(4.72±1.89)年与对照组(1.59±0.67)、(4.77±2.02)年比较,差异无统计学意义(P>0.05);但观察组治疗成本为(3 150.82±163.49)元和成本-效用比(2 327.88±857.63)元显著低于对照组(4 325.67±735.80)元、(3 209.41±1 335.05)元,差异有统计学意义(P<0.05)。结论药物治疗原发性精索静脉曲张性少精子症的有效性虽然低于手术治疗,但其治疗后早期的成本-效用价值更高,可作为手术治疗后的辅助加强方案。

Objective To explore the cost Utility of drugs in the treatment of oligozoospermia of primary varicocele. Methods A total of one hundred and seventy-four patients with oligozoospermia with primary varicocele admitted to the Department of Andrology of Guangdong Family Planning Hospital from January 2019 to June 2019 were selected as the research objects. According to the different treatment methods, they were divided into a drug treatment group(observation group) with 96 cases and an operation treatment group(control group) with 78 cases. Cost effectiveness, treatment cost and health utility index of the two schemes after three months of treatment were compared. The cost utility ratio of the two groups was evaluated by calculating the quality adjusted life years of the two schemes. Results After three months of treatment, the semen improvement rate of the observation group was 46.88%(45/96) lower than that of the control group 53.85%(42/78) but the difference was not statistically significant(χ2 =0.837, P =0.446);the pregnancy rate of spouse was 6.25%(6/96), lower than that of the control group of 11.43%(8/70) but the difference was not statistically significant(χ2=0.934, P=0.406). The health utility value of the observation group was(1.57±0.63), the quality adjusted life year was(4.72±1.89). Compared with(1.59±0.67) yuan,(4.77±2.02) yuan of the control group, and difference was not statistically significant(P>0.05). However, the average cost of treatment in the observation group was(3 150.82±63.49) and the cost utility ratio(2 327.88±857.63) were significantly lower than that in the control group(4 325.67±735.80;(3 209.41±1 335.05), the difference was statistically significant(P<0.05). Conclusion Although the effectiveness of drugs in the treatment of oligozoospermia of primary varicoceleis is lower than that of surgical treatment, its cost Utility value is higher in the later stage of treatment. It can be used as an auxiliary strengthening program after surgical treatment.