3种方案治疗儿童流感样症状的成本效果分析  

Cost-effectiveness analysis of three therapeutic plans for children with influenza-like illness

作　　者：陈圣洁[1] 东蕾[1] 蒋春颖 CHEN Sheng-jie;DONG Lei;JIANG Chun-ying(Department of Pharmacy, Children's Hospital of Hebei Province, Hebei Shijiazhuang 050031, China;Gu'an County People's Hospital of Hebei Province, Hebei Gu'an 065500, China)

机构地区：[1]河北省儿童医院药剂科,河北石家庄050031 [2]河北省固安县人民医院,河北固安065500

出　　处：《中国医院药学杂志》2018年第23期2479-2484,共6页Chinese Journal of Hospital Pharmacy

基　　金：河北省卫生计生委2017年度医学科学研究重点课题(编号:20170391)

摘　　要：目的:评价磷酸奥司他韦颗粒以及联合百蕊颗粒和三臣散治疗儿童流感样症状的经济性。方法:采用前瞻性实际临床试验法将2017年12月-2018年2月门急诊收治的流感样症状患儿270例随机分成奥司他韦颗粒(A组)、磷酸奥司他韦颗粒联合百蕊颗粒(B组)和磷酸奥司他韦颗粒联合三臣散(C组)3组,收集效果和成本数据。从患儿家长角度出发,采用成本-效果法进行分析。结果:实际纳入奥司他韦颗粒82例、磷酸奥司他韦颗粒联合百蕊颗粒82例和磷酸奥司他韦颗粒联合三臣散80例。3组的总有效率分别是80.49%,96.34%,88.75%。差异有显著性(P=0.005<0.05),不良反应发生率分别是6.1%,7.32%,7.5%,差异无显著性(P=0.93>0.05)。3组平均医疗总成本分别是547.63,604.40,590.82元,发热缓解时间分别是2.93,1.99,2.24d,总成本和发热缓解时间均有显著性(P=0.000<0.05)。以总有效率为效果指标,C/E分别是680.37,327.36,665.71,增量成本效果比(ICER)以成本最小的A组为对照,B组358.17,C组522.88。结论:以总有效率为效果指标,磷酸奥司他韦颗粒联合百蕊颗粒在3组中疗效较好,C/E值和并发症较低,是较经济的方案。OBJECTIVE To evaluate the cost-effectiveness of three therapies in the treatment of influenza-like illness (ILI) in children. METHODS A prospective pragmatic clinical trial was conducted among 270 children with ILI collected from the emergency department of Children's Hospital of Hebei Province from December 2017 to February 2018. Patients were divided into 3 groups:group A (oseltamivir phosphate granules), group B (oseltamivir phosphate granules joint Bairui granules), group C (oseltamivir phosphate granules joint Sanchensan powder). From the perspective of the children's family, clinical and cost data were collected for the cost-effectiveness analysis. RESULTS There were 82 children in group A, 82 in group B and 80 in group C for the final trial. The effective rates of the three groups were 80.49%, 96.34% and 88.75%, respectively (P=0.005<0.05). No significant difference was found in the incidence of drug adverse reactions (ADRs) between three groups (group A 6.1%, group B 7.32%, group C 7.5%, P=0.93>0.05). The medical costs of three groups were 547.63, 604.40 and 590.82 yuan, respectively. The fever relief times were 2.93 d,1.99 d and 2.24 d (P=0.000<0.05). "Total efficacy" was used as the effectiveness indicator, the cost-effectiveness ratios (C/E) were 680.37, 327.36 and 665.71, the incremental cost-effectiveness ratios (ICER) were 358.17 in group B and 522.88 in group C. CONCLUSION Of the three therapeutic plans, oseltamivir phosphate granules joint bairui granules is the more economical one with better efficacy, lower C/E and complication in treating children with ILI.

关 键 词：流感样症状 磷酸奥司他韦颗粒 百蕊颗粒 三臣散 成本效果分析 

分 类 号：R952[医药卫生—药学]