含不同剂型克拉霉素片四联疗法对幽门螺旋杆菌感染患者的根除疗效及其经济学评价

Evaluation on Eradication Efficacy and Economics of Quadruple Therapy of Containing Clarithromycin Tablets of Different Dosage Forms in Patients infected by Hp

目的:评价含不同剂型克拉霉素片四联疗法对幽门螺杆菌(Helicobacter pylori,Hp)的根除疗效及其效果-成本。方法:选取2018年12月—2019年11月医院门诊收治的经^(14)C-UBT确诊为Hp感染并经铋剂四联疗法初诊患者102例资料,按治疗用药的不同将其分为A组33例、B组43例和C组26例;各组患者分别停药后4~8周经^(14)C-UBT复查其效果,比较3组患者根除的总有效率以及效果-成本差异,以及不同用药方案的成本-效果比(C/E)和增量成本-效果比(ΔC/ΔE),并通过下调15%药品费用权重敏感性分析,求出和比较其ΔC/ΔE值。结果:3组患者含不同剂型克拉霉素片四联疗法的总有效率分别为87.88%、86.05%和65.38%;以A组为对照组,A、B 2组患者的总有效率经组间比较其差异无统计学意义(P>0.05),而A、C 2组总有效率经组间比较其差异有统计学意义(P<0.05);3组患者的药物费用分别为357.52、474.52和474.52元/人,根除有效率的C/E分别为4.07、5.52和7.26,B、C 2组相对于A组的ΔC/ΔE分别为-61.58和-5.20,权重敏感性分析支持成本-效果分析结果。结论:Hp根除方案中克拉霉素片的疗效及经济学优于其缓释片,更值得推荐用于Hp的根除疗法。

Objective:To evaluate the eradication efficacy and pharmacoeconomics of quadruple therapy containing clarithromycin tablets of different dosage forms in patients infected by Helicobacter pylori(Hp).Methods:From December 2018 to November 2019,102 patients with Hp infection confirmed by ^(14)C-UBT and newly diagnosed by bismuth quadruple therapy were selected and divided into group A(33 cases),Group B(43 cases)and Group C(26 cases)based on different therapeutic agents.The efficacy of each group was examined by ^(14)C-UBT after 4-8 weeks of drug withdrawal.The total effective rate and the efficacy of eradication-cost difference and different regimen of cost-effectiveness ratio(C/E)and the incremental cost-effectiveness ratio(ΔC/ΔE),and sensitivity analysis to weight by a 15%lower the drug prices and the drug cost and theirΔC/ΔE value were compared.Results:The total effective rates of the 3 groups were 87.88%,86.05%and 65.38%,respectively.With group A as the control group,there were no statistically significant differences in the total effective rate between groups A and B(P>0.05),while the total effective rate between groups A and C was statistically significant(P<0.05).3 groups of patients with drug costs were 357.52,474.52,and474.52 RMB/person,the eradication of efficient C/E of 4.07,5.52 and 7.26,respectively,B and C in the two groups compared with group AΔC/ΔE 61.58 and 5.20,respectively,the cost-effectiveness results of sensitivity analysis to weight were supported.Conclusions:The efficacy and pharmacoeconomics of clarithromycin tablets in Hp eradication program were better than those of sustained-release tablets,which was more worthy of recommendation for Hp eradication therapy.