华法林与利伐沙班防治房颤患者脑卒中的药物经济学分析

Pharmacoeconomical analysis of warfarin vs rivaroxaban in the prevention and treatment of stroke in patients with atrial fibrillation

目的 分析华法林和利伐沙班防治心房颤动(房颤)患者脑卒中的药物经济学,为中国房颤患者抗凝药物的合理使用提供依据。方法 69例住院的房颤患者,根据用药不同分为对照组(38例)和实验组(31例)。对照组采用华法林钠片进行抗凝治疗,实验组采用利伐沙班片进行抗凝治疗。运用药物经济学原理对两种治疗方案进行成本-效果分析(CEA)及敏感性分析。结果 实验组总成本为1420.14元,高于对照组的483.69元;实验组的质量调整生命年(QALYs)为0.466,优于对照组的0.401。两种药物的增量成本-效果比(ICER)为14296.95元/QALY。敏感性分析结果显示:在改变药品成本及贴现率的情况下,利伐沙班较华法林的ICER均小于人均GDP。结论 在中国背景下,新型口服抗凝药利伐沙班较华法林而言具有一定的药物经济学优势,值得临床推广使用。

Objective To analyze the pharmacoeconomics of warfarin vs rivaroxaban in the prevention and treatment of stroke in patients with atrial fibrillation,so as to provide basis for rational use of anticoagulant drugs in AF patients in China.Methods A total of 69 hospitalized patients with atrial fibrillation were divided into control group(38 cases)and experimental group(31 cases)according to different drug use.The control group used warfarin sodium tablets for anticoagulation,the experimental group used rivaroxaban tablets for anticoagulation.Cost-effectiveness analysis(CEA)and sensitivity analysis were carried out based on pharmacoeconomics.Results The total cost of the experimental group was 1420.14 yuan,which was higher than that of 483.69 yuan of the control group;the quality-adjusted life years(QALYs)of the experimental group was 0.466,which was better than that of 0.401 of the control group.The incremental cost-effectiveness ratio(ICER)of the two drugs was 14296.95 yuan/QALY.Sensitivity analysis results showed that the ICER of Rivaroxaban and Warfarin was less than the per capita GDP when the drug cost and discount rate were changed.Conclusion Under current economic situations in China,rivaroxaban,a new oral anticoagulant,has certain advantages in pharmacoeconomics than warfarin,which is worthy of clinical promotion and application.