美托洛尔、比索洛尔治疗伴高血压的慢性充血性心力衰竭的成本-效果比较

Cost-effectiveness comparison of metoprolol and bisoprolol in treating chronic congestive heart failure complicating hypertension

目的 比较美托洛尔、比索洛尔治疗伴高血压的慢性充血性心力衰竭(CHF)的成本-效果。方法 选取2021年12月至2022年5月该院收治的126例伴高血压的CHF患者为研究对象,按照随机数字表法分为美托洛尔组和比索洛尔组,各63例。美托洛尔组在常规药物基础上给予美托洛尔治疗,比索洛尔组在常规药物基础上给予比索洛尔治疗,30 d为1个疗程,均治疗3个疗程。对比2组治疗成本、临床疗效、不良反应,并进行成本-效果分析及敏感性分析。结果 治疗90 d,比索洛尔组和美托洛尔组的药费分别为197.46元、154.26元,比索洛尔组、美托洛尔组的平均治疗总成本分别为(4 105.47±102.48)、(4 063.52±103.61)元;比索洛尔组的疗效优于美托洛尔组,差异有统计学意义(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05);比索洛尔组和美托洛尔组的成本-效果比(C/E)分别为46.19、54.47,比索洛尔组的增量成本-效果比(ΔC/ΔE)为2.94;该研究将成本价格下调10%进行敏感性分析,比索洛尔组的C/E为41.57,美托洛尔组的C/E为49.02,比索洛尔组的ΔC/ΔE为2.64,敏感性分析结果与C/E分析结果一致。结论 比索洛尔治疗伴高血压的CHF临床疗效优于美托洛尔,且更具有经济性,临床可优先选择比索洛尔。

Objective To compare the cost-effectiveness of metoprolol and bisoprolol in the treatment of chronic congestive heart failure(CHF)complicating hypertension.Methods A total of 126 patients with chronic CHF complicating hypertension admitted and treated in this hospital from December 2021 to May 2022 were selected as subjects and divided into the metoprolol group and bisoprolol group according to random number table method,63 cases in each group.The metoprolol group was given metoprolol on the basis of the conventional drugs,and the bisoprolol group was given bisoprolol on the basis of conventional drugs.Thirty days was a course of treatment,and both groups were treated for 3 courses.The treatment cost,clinical efficacy and adverse reactions were compared between the two groups,and the cost-effectiveness analysis and sensitivity analysis were carried out.Results After 90 d treatment,the drug expenses of the bisoprolol group and metoprolol group were 197.46 Yuan and 154.26 Yuan respectively,and the average total treatment cost of the bisoprolol group and metoprolol group were(4105.47±102.48)Yuan and(4063.52±103.61)Yuan respectively.The effect of the bisoprolol group was superior to that of the metoprolol group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).The cost-effectiveness ratios(C/E)of the bisoprolol group and metoprolol group were 46.19 and 54.47 respectively,and the incremental cost-effectiveness ratio(ΔC/ΔE)of the bisoprolol group was 2.94.In this study,the cost price was reduced by 10%for conducting the sensitivity analysis,and C/E of the bisoprolol group was 41.57,which of the metoprolol group was 49.02,and theΔC/ΔE of the bisoprolol group was 2.64,and the sensitivity analysis results were consistent with the cost-effectiveness ratio analysis results.Conclusion The clinical efficacy of bisoprolol in the treatment of chronic CHF complicating hypertension is superior to that of the metoprolol,and it is more economical.Therefore,bisoprolol can be given priority in clinical practice.