基于真实世界的注射用矛头蝮蛇血凝酶围术期应用的经济学评价

Economic evaluations of perioperative use of hemocoagulase bothrops atrox:a real-world based study

目的:评估注射用矛头蝮蛇血凝酶在围术期应用的经济性。方法:回顾性收集2023年3月全国22个省40家三甲医疗机构的住院手术患者成本和疗效数据,分为注射用矛头蝮蛇血凝酶(HCB)组、注射用尖吻蝮蛇血凝酶(HA)组及凝血酶散(LT)组。倾向性评分匹配基线特征,采用最小成本法和成本效果法进行经济性分析。结果:与注射用尖吻蝮蛇血凝酶和凝血酶散组相比,注射用矛头蝮蛇血凝酶组出院转归无差异,住院时间缩短(HCB组vs.HA组:9.304 d vs.10.62 d,P<0.01;HCB组vs.LT组:9.336 d vs.11.02 d,P<0.01),人均住院总费用降低(HCB组vs.HA组:32148元vs.38114元,P<0.01;HCB组vs.LT组:35957元vs.59992元,P<0.01)。与注射用尖吻蝮蛇血凝酶组相比,注射用矛头蝮蛇血凝酶组人均血凝酶制剂费用降低(342.54元vs.426.56元,P<0.01),与凝血酶散组相比人均血凝酶制剂费用无差异。结论:注射用矛头蝮蛇血凝酶应用于围术期的经济性优于其他两组。

OBJECTIVE To evaluate the economics of hemocoagulase bothrops atrox for injection(HCB).METHODS The cost and efficacy data of hospitalized patients were collected retrospectively from 40 tertiary medical institutions across 22 domestic provinces during March 2023.The subjects were assigned into three groups of HCB,hemocoagulase agkistrodon for injection(HA)and lyophilizing thrombin powder(LT).Propensity score method(PSM)was utilized for matching the baseline profiles.Economic analysis was conducted by cost minimization and cost-effectiveness.RESULTS No difference existed in dis⁃charge outcome among three groups.However,HCB exhibited significantly shorter hospitalization days than HA/LT(HCB group vs.HA group:9.304 d vs.10.62 d,P<0.01;HCB group vs.LT group:9.336 d vs.11.02 d,P<0.01).Additionally,total hospitalization cost per capita was lower in HCB than HA/LT(HCB group vs.HA group:¥32148 vs.¥38114,P<0.01;HCB group vs.LT group:¥35957 vs.¥59992,P<0.01).As compared with HA,cost of hemocoagulase preparation declined in HCB(¥342.54 vs.¥426.56,P<0.01).No difference existed in cost of hemocoagulase preparation between HCB and LT.CONCLUSION HCB is more cost-effective than LT/HA in perioperative period.