氟西汀治疗持续的躯体形式疼痛障碍的成本-效果分析  

Cost-effectiveness analysis of fluoxetine for patients with persistent somatoform pain disorder

作　　者：骆艳丽[1] 张明园[2] 吴文源[1] 李春波[2] 姚军[1] 李清伟[1] 

机构地区：[1]上海同济大学附属同济医院精神医学科,200065 [2]上海交通大学附属精神卫生中心

出　　处：《中华精神科杂志》2009年第2期71-74,共4页Chinese Journal of Psychiatry

基　　金：基金项目：上海市科学技术委员会资助项目（014119073）

摘　　要：目的初步探索氟西汀治疗持续的躯体形式疼痛障碍（PSPD）的成本-效果分析。方法将80例PSPD患者随机分为氟西汀组和安慰剂组，每组各40例，分别服用氟西汀胶囊（20mg/d）和安慰剂胶囊（1粒／d）8周，研究者和患者双盲。调查人组前后直接医疗成本，计算两组患者人组前后共4个月的成本与效果比值。结果（1）氟西汀组有效率为40％，安慰剂组有效率为8％。（2）氟西汀组和安慰剂组成本与效果比值分别为0．53万元（5345元）和1．83万元（18345元）。（3）敏感度分析，氟西汀组和安慰剂组的成本与效果比值分别为0．40万元（4033元）和1．22万元（12188元）。结论应用氟西汀治疗PSPD的成本与效果比值较低，具有较好的药物经济学价值。Objective The objective of this study was to analyze cost-effectiveness ratio of fluoxetine as a treatment for patients suffering from persistent somatoform pain disorder. Methods This study was a randomized, double-blind, placebo-controlled study. Patients （n = 80 ） with persistent somatoform pain disorder for 6-120 months were recruited. Patients were randomly allocated to receive fluoxetine （20 mg/d） or placebo （ 1 tab/d） for 8 weeks. The primary clinical outcome was the Medical Outcomes Study Pain Measures （MOSPM）. Direct medical costs were measured from patients and their family for total experiment duration and the previous 2 months. Effectiveness was measured with responsive rate. Differences in costs between both groups prior to the trial were not statistically significant. Results The responsive rate in fluoxetine group was 40% （ 16/40）, and 8% （3/40） in placebo group. Cost- effectiveness ratio analysis showed that every patient spent 5345 yuan and 18 345 yuan to acquire 1% responsive rate in fluoxetine group and placebo group respectively. Sensitivity analysis result showed that patient in fluoxetinc ~r,,up needed 4033 yuan and patient in placebo group needed 12 188 yuan to acquire 1% responsive rate. Conclusion For persistent somatoform pain disorder, fluoxetine is more cost-effective than placebo.

关 键 词：疼痛 氟西汀 经济学 药学 费用效益分析 持续的躯体形式疼痛障碍 

分 类 号：R686[医药卫生—骨科学]