帕罗西汀、文拉法辛及西酞普兰治疗抑郁症的成本-效果分析  

Cost-effectiveness analysis of depression treatment with paroxetine, venlafaxine and citalopram

作　　者：潘康月[1] 刘小玉[2] 杨继章[1] 朱琳[1] 王小敏[2] 杨树民[1] 

机构地区：[1]河北医科大学第一医院药剂科,河北省石家庄市050031 [2]河北医科大学第一医院精神卫生中心,河北省石家庄市050031

出　　处：《中国临床康复》2005年第28期16-18,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:评价帕罗西汀、文拉法辛、西酞普兰治疗抑郁症的经济效果。方法:选择2002-01/2004-12河北医科大学第一医院精神卫生中心收治的抑郁症住院患者90例。随机分为3组:帕罗西汀组和文拉法辛组及西酞普兰组,每组30例。帕罗西汀组口服帕罗西汀片20～50mg/d,1次/d。文拉法新组口服文拉法新胶囊75～375mg/d,3次/d。西酞普兰组口服西酞普兰片20～60mg/d,1次/d。各组平均疗程分别为45,70,84d。采用汉密顿抑郁量表于治疗前及治疗后1,2,4,6,8周进行疗效评定,以汉密顿抑郁量表减分率为疗效评价指标,≥75%为显效;≥50%为有效;<50%为无效。采用副反应量表进行不良反应评定,要求对每项症状作3方面的评定:严重度,症状和药物的关系以及采取的措施。并及时记录。并运用成本-效果分析方法进行成本和效果的确定,成本包括药品成本,治疗成本,检查成本,住院成本,时间成本;效果以总有效率作为各组药物治疗方案的衡量指标。总有效率=(显效例数+有效例数)/总例数×100%。成本-效果采用单位效果所花费的成本来表示,增量成本-效果分析代表一个方案的成本-效果与另一个方案比较而得的结果,通常以最低效果组为参照进行计算,本文以西酞普兰组为基础对照。同时进行敏感度分析。假设药品费用下降5%,治疗费用、检查费用、住院费用、时间费用各增长1%,总成本发生的相应变化。结果:90例患者均进入结果分析。①帕罗西汀组、文拉法辛组、西酞普兰组总有效率分别为93%、90%、80%。帕罗西汀组与文拉法辛组总有效率接近,文拉法辛组与西酞普兰组总有效率差异不明显(P>0.05);西酞普兰组与帕罗西汀组总有效率差异显著(P<0.05)。②帕罗西汀组、文拉法辛组、西酞普兰组每日成本分别为222.63,155.94,155.37元,总成本为10018.35,10915.80,13051.08元。③帕罗西汀组、文拉法辛组、西酞普兰组单�AIM： To evaluate the economic effectiveness of paroxetine, venlafaxine and citalopram in treating depression.MEEHODS： Ninety inpatients with depression in Mental Health Center of the First Hospital of Hebei Medical University between January 2001 to December 2004 were randomly divided into three groups with 30 cases in each group： Group A was treated with paroxetin, Group B with venlafaxine and group C with citalopram. Patients in group A took the tablets of paroxetin 20-50 mg once a day. Those in Group B took the capsules of venlafaxine 75-375 mg, three times a day. Patients in Group C took the tablets of citalopram 20-60 mg, once a day. The average course of treatment was 45 days, 70 days and 84 days respectively. Effectiveness evalua tion had been made during the 1^st, 2nd, 4^th, 6^th and 8^th weeks respectively by using Hamilton depression rating scale （HAMD） and its reduction rate as the effectiveness evaluation standard. More than 75% or 75% even was going to excellence effectiveness. More than 50% or 50% even had the effectiveness. Less than 50% had no effectiveness. Adverse drug reaction had been evaluated by using the side reaction measuring scale, requiring the evaluation on each symptom be made in three regards： severity, relationship between symptom and medication and measures taken. Records had been made accordingly. Cost and effectiveness were determined through cost-effectiveness analysis. Cost included the use of drugs, treatment, examination, hospitalization and time. Effectiveness was based on the total effectiveness, which was the evaluation standard in each therapeutic scheme.Total effectiveness was equal to cases showing the effect plus cases having the effect/total number of patients^100%. Cost-effectiveness was shown by unit effectiveness cost. Cost-effectiveness analysis in amount increase represents the result from the comparison between two different schemes. Calculation was usually made according to the least effectiveness. The article used the group with citalopram as a bas

关 键 词：帕罗西汀 抑郁症 成本-效果分析 

分 类 号：R749.7[医药卫生—神经病学与精神病学]