5种社区常用单片复方制剂降压药成本-效果分析  

The cost-effectiveness analysis of antihypertensive drugs of five kinds of single pill combination used frequently in communities

作　　者：冯芮华[1] 王小万[1] 王增武[2] 李建[1] 王馨[2] 陈祚[2] 崔月颖[1] 朱曼璐[2] 

机构地区：[1]中国医学科学院卫生政策与管理研究中心,北京100020 [2]中国医学科学院阜外心血管病医院,国家心血管病中心社区防治部

出　　处：《中华高血压杂志》2015年第3期252-255,共4页Chinese Journal of Hypertension

基　　金：卫生行业科研专项(200902001)

摘　　要：目的评价社区5287例高血压患者规范化管理中,5种常用单片复方制剂复方罗布麻片、复方降压片、复方地巴唑氢氯噻嗪、北京降压0号和复方利血平治疗1年的成本-效果。方法基于经济发展水平和地理位置,选择16个省250个社区卫生服务中心(站)和卫生院,利用基层高血压规范化管理方案对社区医务人员进行培训,由受培训的基层医务人员对高血压患者实施规范化管理1年。高血压患者的基线和随访资料采用统一设计的调查问卷收集。采用成本-效果分析法评价单片复方制剂治疗的经济效果。结果与其他3种复方制剂比较,复方罗布麻片(29.2元)和复方降压片(32.9元)的年人均成本较低;复方地巴唑氢氯噻嗪[(9.6±8.1)%,(8.6±8.0)%]和复方罗布麻片[(9.5±7.3)%,(8.5±8.8)%]的平均收缩压和舒张压下降率较大;复方地巴唑氢氯噻嗪(75.3%)和复方利血平(58.5%)的血压控制率较高。总体,复方罗布麻片和复方地巴唑氢氯噻嗪的成本-效果比较低。结论在社区单片复方制剂降压效果方面,复方罗布麻片和复方地巴唑氢氯噻嗪具有较好的成本-效果。Objective To evaluate the cost effectiveness of five kinds of single pill combination for antihypertensive treatment for 1 year in the process of community-based standardized blood pressure management. Methods Two hundred and fifty community health centers （stations） and township hospitals were selected across 16 provinces of China according to geographical locations and economic levels. The primary care physicians were trained in accord- ance with the guidelines for prevention and control for hypertension in China, and they were required to implement standardized blood pressure management for hypertensive patients for 1 year. For each hypertensive patient, infor- mation at both baseline and follow-up was collected using a uniform case report form. The economic effectiveness of single pill combination for antihypertensive treatment was evaluated using the cost effectiveness analytical method. Results The annual mean cost was lower for compound Apocynum tablet （￥29.2） and compound Antihypertension tablet （51532.9） than for the other three kinds of tablets. The mean reduction rate of systolic and diastolic blood pressure was higher for compound Bendazol and Hydroehlorothiazide tablet [ （ 9.6± 8.1 ） % and （ 8.6 ± 8.0 ） % ] and compound Apocynum tablet [（9.5±7.3）% and （8.5±8.8）%] than for the others. The control rate of blood pressure was higher for compound Bendazol and Hydrochlorothiazide tablet （75.3%） and compound Reserpine （58.5%） tablet than for the others. The cost-effectiveness ratio was lower for compound Apocynum tablet and compound Bendazol and Hydrochlorothiazide tablet. Conclusion In terms of the antihypertensive effect of single pill combination in multiple communities, compound Apocynum and compound Bendazol and Hydrochlorothiazide proved to be cost-effective than the others.

关 键 词：社区 高血压 管理 单片复方制剂 成本-效果 

分 类 号：R544.1[医药卫生—心血管疾病]