药品集中带量采购前后头孢哌酮舒巴坦治疗社区获得性肺炎的疗效、成本-效果和安全性比较

Efficacy,cost-effectiveness,and safety analysis of cefoperazone-sulbactam in the treatment of community-acquired pneumonia before and after centralized procurement

目的比较药品集中带量采购前后头孢哌酮舒巴坦在社区获得性肺炎治疗中的有效性、成本-效果及安全性。方法采用回顾性研究方法。选取医院药品集中带量采购前(集采前,2022年1-6月)和集中带量采购后(集采后,2023年1-6月)使用头孢哌酮舒巴坦治疗的社区获得性肺炎患者,分别有71例和80例。采集患者的临床资料后进行整理、分析,评估并比较带量采购前后头孢哌酮舒巴坦在社区获得性肺炎中的疗效、成本-效果和安全性。结果集采前与集采后头孢哌酮舒巴坦在社区获得性肺炎中的治疗有效率分别为83.10%和60.00%(P<0.01);细菌清除率分别为44.44%和28.57%(P>0.05);集采后治疗总费用、人日均治疗费用、抗菌药物费用、药物治疗费用和药占比方面均较集采前有明显下降(P<0.05),集采后的增量成本-效果比为194.09。集采前及集采后不良反应发生率分别为4.29%和5.00%(P>0.05)。结论虽然头孢哌酮舒巴坦在集采后临床有效率稍逊于集采前,但集采后经济学方面有较明显的优势,可有效减轻患者住院费用负担,节约医疗成本。

AIM To compare the effectiveness,cost-effectiveness,and safety of cefoperazone-sulbactam before and after the implementation of centralized drug procurement in the treatment of community-acquired pneumonia.METHODS A retrospective analysis was conducted on the real-world data of cefoperazone-sulbactam used in treating patients with community-acquired pneumonia in the period before(referred to as pre-procurement,n=71)from January to June 2022 and after(referred to as post-procurement,n=80)from January to June 2023 in the hospital.The collected data were summarized and analyzed to evaluate the effectiveness,cost-effectiveness,and safety of cefoperazonesulbactam before and after centralized drug procurement in the community-acquired pneumonia setting.RESULTS The clinical effectiveness rates before and after procurement were 83.10%and 60.00%,respectively,with a statistically significant difference(P<0.01).The bacterial clearance rates were 44.44%and 28.57%,respectively,with no statistically significant difference(P>0.05).After procurement,there was a significant decrease in total treatment cost,cost per person-day,antibiotic cost,medication cost,and medication cost ratio(P<0.05).The incremental cost-effectiveness ratio after procurement is 194.09.The incidence of adverse reactions before and after procurement was 4.29%and 5.00%,respectively,with no statistically significant difference(P>0.05).CONCLUSION The clinical efficacy of cefoperazone after collection is slightly lower than that before collection,but there is no significant difference in bacterial clearance rate.However,there are significant economic advantages after procurement,effectively reducing the financial burden on patients and saving medical costs.There is no significant difference in the incidence of adverse reactions between the 2groups.