4种核苷类药物治疗慢性乙型肝炎2年的成本-效果分析.pdfVIP

Pharmacy Today • 2012 仍 Vol. 22 No.5 • 4 种核背类药物治疗慢性乙型肝炎 2 年的 成本-效果分析 宋玲美，叶晓光 (广州医学院第二附属医院感染科，广东广州 510260) 摘要:目的对推米夫定、阿德福韦醋、替比夫定和恩替卡韦 4 种药物治疗慢性乙型肝炎 2 年作成本-效果分析，找出适合临床的最佳 治疗方案。方法对本科门诊诊治的 2∞例慢性乙型肝炎患者的 2 年诊疗经过和疗效进行统计，包括肝功能指标 ALT 复常率、HBVD­ NA 转阴率、HBeAg 转阴率及其血清学转换率和耐药率。计算药物单价、疗程费用、药物成本·效果及敏感度分析。结果这 4 种药物 拉米夫定、阿德福韦醋、替比夫定和恩替卡韦均对治疗慢性乙型病毒性肝炎有效，疗效分别为 7.81.)岛， 3.29岛，35.8% 和 86% 。成本­ 效果比值分别为 1379.99 元、4 129.12 元、4ω.55 元和 308.73 元。以恩替卡韦为基准，每增加一个效果单位拉米夫定、阿德福韦醋、 替比夫定分别需要增加却1. 88 元， 16 1. 08 元，2ω.47 元。篝it 治疗慢性乙型肝炎 2 年以恩替卡韦布效率最高，成本-效果值最低， 效果最佳。 关键询:慢性乙型肝炎;成本-效果:治疗;核管类药物 中国分类号:即7 文献标志码:A 文章编号 :1673 -4610(2012)05 -0260-04 Cost-Effectiveness Analysis of 4 Kinds of Nucleoside Treatment for Chronic Hepatitis 8 in 2 Years SONG Ling-ying , YE Xiao-gua吨 (Department of Infectious Diseases. the Second Affiliated Hospital of Guangzhou Medical College • Guangzhou , Guangdong 51但60 ， China) Abstract: Objective To evaluate the cost-effectivene5S of 4 nucleosides (lamivudine. adefovir. telbivudine. and entecavirr )略剖nst chronic Hepatitis B and to find appropriate proposal. Methods 咀le efficacy and cost of 2∞ patJents who were treated over 2 y销路 with chronic hepatitis B in 0盯 outpatient were calculated. including their serum ALT nonnalization , reductions in serum HBV DNA level , HBeAg 105S and ser，悦。nver冒ion and the rate of 企ug resistance. 咀le cost of lamivudine , adefovir , telbivudine entecavir and cost-effectiveness was calculated. Resultsηle four medicine all had better effective. E伍cacy of lamivudine , adefovir dipivoxil , telbivudine and entecavir treatment were 7. 8% , 3.2% • 35.8% , and 8M忠. respectively. 咀le ratio of cost-effectiveness were 1 379.99. 4 129. 口， 4ω.55 ， and 308.73 Yu四. As a benchmark to entecavir. each additional unit of effect of lamivudine. adefovir dipivoxil , telbivudine , need increased investment of 201.邸， 161. 08 , 2∞. 47 RMB , resp优tively. Conclusion Among the 4 medicine , Entecavir has the highωt effjciency , lowest potency of C/E values. the best of co