基于倾向指数匹配法的ARB类两种降压药物的成本-效果分析

Cost-effectiveness Analysis of Two Kinds of ARB Antihypertensive Drugs Based on Propensity Score Matching Method

目的基于倾向指数匹配法评价血管紧张素受体拮抗剂(ARB)类降压药物厄贝沙坦与阿利沙坦酯两种降压药物的成本-效果。方法选取2018年1月-2021年6月河南省某三甲心血管病医院服用厄贝沙坦与阿利沙坦酯的门诊高血压患者,以患者治疗方案为因变量,以协变量(所有影响抗高血压药物治疗效果的变量)为自变量建立Logistic回归模型,计算高血压患者的倾向指数,以倾向指数为距离函数进行样本卡钳匹配,利用匹配后的样本进行成本-效果分析。结果匹配后协变量在服用厄贝沙坦组和服用阿利沙坦酯组两组之间的分布达到很好的均衡;在收缩压和舒张压下降率上,阿利沙坦酯片(信立坦)(308.66、657.21)的成本-效果较厄贝沙坦片(安博维)(135.71、101.54)升高2.5倍左右。结论与阿利沙坦酯比较,厄贝沙坦的成本-效果更好。

Objective To evaluate the cost-effectiveness of two kinds of angiotensin receptor blockers irbesartan and allisartan isoproxil based on propensity score matching method.Methods From January 2018 to June 2021,outpatients with hypertension who took irbesartan and allisartan isoproxil in a tertiary cardiovascular hospital in Henan Province were selected.The patient's treatment plan was used as the dependent variable,and the covariate(all variables affecting the therapeutic effect of antihypertensive drugs)was used as the independent variable to establish a Logistic regression model.The propensity index of hypertensive patients was calculated,and the propensity index was used as the distance function to match the sample caliper.The matched samples were used for cost-effectiveness analysis.Results After matching,the distribution of covariates between the irbesartan group and the allisartan isoproxil group reached a good equilibrium.In terms of systolic and diastolic blood pressure reduction rates,the cost-effectiveness of allisartan isoproxil tablets(308.66,657.21)was about 2.5 times higher than that of irbesartan tablets(135.71,101.54).Conclusion Compared with allisartan isoproxil,the cost-effectiveness of irbesartan is better.