多囊卵巢综合征患者行辅助生殖的药物经济学分析

Pharmacoeconomic analysis of assisted reproduction in patients with polycystic ovary syndrome

目的探讨多囊卵巢综合征(PCOS)患者行辅助生殖的药物经济学特征及规律,为PCOS患者的辅助生殖提供参考。方法选取391例PCOS患者作为研究对象,通过病例注册研究方法收集真实世界PCOS患者病例的经济学数据进行分析。结果完成PCOS患者病例注册资料391例,年龄19~40岁,病程2~180个月;截至末次随访,成功妊娠98例,未妊娠293例,妊娠率为25.06%。PCOS患者成功妊娠的直接医疗成本高于未成功者,差异有统计学意义(P<0.05)。接受指导同房的直接医疗成本与妊娠成功率低于试管婴儿、人工授精,差异有统计学意义(P<0.05)。人工授精未孕,行试管婴儿的直接医疗成本与妊娠成功率高于人工授精、试管婴儿、指导同房,差异有统计学意义(P<0.05)。结论PCOS患者辅助生殖的直接医疗成本与其接受的辅助生殖技术有关,试管婴儿的妊娠成功率高,但直接医疗成本亦较高。指导同房直接医疗成本低,少部分PCOS患者能够成功妊娠。人工授精未孕,行试管婴儿的成功率与直接医疗成本最高。

Objective To investigate characteristics and rules of assisted reproduction in polycystic ovary syndrome pharmacoeconomic(PCOS)patients,to provide reference for assisted reproduction in PCOS patients.Methods 391 PCOS patients were selected as the research objects,and the economic data of real world PCOS patients were collected and analyzed by case registration.Results 391 patients with PCOS were registered,aged 19~40 years,disease course 2~180 months.Up to the last follow-up,there were 98 successful pregnancies and 293 non-pregnancies,with a pregnancy rate of 25.06%.The direct medical costs for PcoS patients with successful pregnancies are higher than those with unsuccessful pregnancies.Direct medical costs and pregnancy success rates of guided sex were lower than those of IVF and artificial insemination,the differences were statistically significant(P<0.05).The direct medical cost and pregnancy success rate of IVF after artificial inseminatior were higher than those of IVF,artificial inseminatior and guided sex,the differences were statistically significant(P<0.05).Conclusion The direct medical cost of assisted reproduction in PCOS patients is related to the assisted reproductive technology they receive.The pregnancy success rate of IVF is high,but the direct medical cost is also high.Direct medical costs are low,and a small number of PcoS patients can pregnancy successful.In artificial inseminatior without pregnancy,the success rate and direct medical costs of IVF are the highest.