老年高血压患者应用缬沙坦、苯磺酸氨氯地平、缬沙坦氨氯地平治疗的成本-效果分析

Cost-effectiveness analysis of valsartan,amlodipine besylate,valsartan amlodipine in the treatment of elderly patients with hypertension

目的探讨缬沙坦、苯磺酸氨氯地平、缬沙坦氨氯地平治疗老年高血压患者的成本-效果。方法回顾性分析110例老年高血压患者的临床资料,依据使用的降压药将其分为A组(缬沙坦)33例、B组(苯磺酸氨氯地平)36例、C组(缬沙坦氨氯地平)41例。比较3组治疗疗效、治疗前和治疗4周后血压水平[24h平均收缩压(24hSBP)、24h平均舒张压(24hDBP)、夜间收缩压(nSBP)、夜间舒张压(nDBP)、日间收缩压(dSBP),日间舒张压(dDBP)];记录3组治疗期间不良反应总发生率,比较3组成本-效果比(CER)与增量成本-效果比(ICER)。结果治疗4周后,三组间总有效率、24hSBP、24hDBP、nSBP、nDBP、dSBP、dDBP和不良反应总发生率差异均无统计学意义(均P>0.05)。B、A、C组的成本、CER均依次升高(均P<0.05);三组中B组降低的24hSBP值最小,差异无统计学意义(P>0.05);以B组为对照,A组ICER为125.19元,C组ICER为98.78元。结论缬沙坦、苯磺酸氨氯地平、缬沙坦氨氯地平均可有效地治疗老年高血压患者,三者的安全性相当,其中苯磺酸氨氯地平成本最低,缬沙坦氨氯地平治疗也较缬沙坦更具药物经济学优势。

Objective To investigate the cost-effectiveness of valsartan,amlodipine besylate,and valsartan amlodipine in the treatment of elderly patients with hypertension.Methods The clinical data of 110 elderly patients with hypertension were retrospectively analyzed,and they were divided into group A(valsartan)(n=33),group B(amlodipine)(n=36),or group C(valsartan amlodipine)(n=41)according to their antihypertensive drugs.The treatment efficacy and blood pressure levels(24-hour systolic blood pressure[24hSBP],24-hour diastolic blood pressure[24hDBP],night-time systolic blood pressure[nSBP],night-time diastolic blood pressure[nDBP],day-time systolic blood pressure[dSBP],and day-time diastolic blood pressure[dDBP])before treatment and after 4 weeks of treatment were compared between the three groups,the total incidences of adverse reactions during the treatment in the three groups were recorded,and the cost-effectiveness ratio(CER)and incremental cost-effectiveness ratio(ICER)of the three groups were compared.Results After 4 weeks of treatment,there was no statistically significant difference in the total effective rate,24hSBP,24hDBP,nSBP,nDBP,dSBP,dDBP,or the total incidence of adverse reactions between the three groups(all P>0.05).The cost and CER of groups B,A,and C increased successively(all P<0.05);among the three groups,group B had the smallest decrease in 24hSBP,but the difference was not statistically significant(P>0.05);taking group B as the control,the ICER of group A was 125.19 yuan,and the ICER of group C was 98.78 yuan.Conclusion Valsartan,amlodipine besylate,and valsartan amlodipine can effectively treat elderly patients with hypertension,with comparable safety;among which amlodipine besylate has the lowest cost,and valsartan amlodipine also has more pharmacoeconomic advantages than valsartan in the treatment.