四种常用保肝药治疗药物性肝损伤的药物经济学分析  

Pharmacoeconomic profiles of four hepatoprotective drugs used for the treatment of drug-induced liver injury

作　　者：黄广宇[1] 王宇明[1] 

机构地区：[1]第三军医大学西南医院感染科,全军感染病研究所,重庆400038

出　　处：《中华肝脏病杂志》2014年第10期763-768,共6页Chinese Journal of Hepatology

摘　　要：目的评价4种常用保肝药物治疗药物性肝损伤的经济学效果。方法构建决策分析模型，率值参数来源于文献资料的Meta分析结果，效果参数来源于专家意见，成本参数如使用规格、数量和单价来源于文献资料、专家意见、国家卫生和计划生育委员会与国家发展和改革委员会最新发布数据等。结果4种用药方案中，双环醇组治疗效果（4.5118）最好、成本-效果比（86.2667）较小，增量成本-效果比（245.0118）最小且安全性最好；硫普罗宁肠溶片组治疗效果（4.1352）较差，但成本（296.9536）最低；以显效率作为产出计算，双环醇组显效率（73.10）最高，且成本-效果比（5.32）最低，增量成本效果比（4.93）最小。敏感度分析证实这一结果可靠。结论双环醇可安全、有效的治疗药物性肝损伤，且具有成本效果优势。Objective To perform a pharmacoeconomic evaluation of the efficacies of therapeutic schemes involving four hepatoprotective drugs for the treatment of drug-induced liver injury （DILI）. Methods The principle of decision tree analysis in pharmacoeconomies was applied to perform a retrospective analysis using a meta-analyses approach to evaluate the data from randomized controlled trials of four common therapeutic schemes. The key parameters for evaluating efficacy and safety of each were identified by searching the official data, relevant literature and expert opinions, and included the parameters of consumption and unit cost with respect to a variety of health resources. Results The hepatoprotective drug showing the greatest efficacy （4.5118） and safety for treating DILI was bicyclol; this drug also had a lower incremental cost-effectiveness ratio （ICER; 245.0118） than the other three therapeutic schemes. The tioproninenteric-coated tablet had the lowest cost （296.9536） among the four, but also had the worst efficacy （4.1352）. Bicyclol had the lowest cost/benefit ratio （5.32） and ICER （4.93） among all the therapeutic schemes evaluated. Sensitivity analyses confirmed the robustness of these results. Conclusion According to this pharmacoeconomic evaluation, the bicyclol therapeutic strategy is the most cost-effective choice for DILI.

关 键 词：药物性肝损伤 经济学 药学 决策树 

分 类 号：R575[医药卫生—消化系统]