以血管紧张素Ⅱ受体拮抗剂类药物为模板的基本药物遴选方法探讨  

Investigation on the method of essential medicines selection： angiotensin Ⅱ receptor antagonist drugsas templet

作　　者：李晓玲[1] 闫素英[1] 王育琴[1] 赵程程[1] 陆璐[1] 

机构地区：[1]首都医科大学宣武医院药剂科,北京100053

出　　处：《药物不良反应杂志》2015年第4期247-252,共6页Adverse Drug Reactions Journal

基　　金：国家卫生与计划生育委员会委托课题（2012-2015年）

摘　　要：目的以血管紧张素Ⅱ受体拮抗剂（ARB）类药物为模板，探讨我国基本药物的遴选方法。方法以《中国高血压防治指南2010}推荐的ARB类药物氯沙坦、缬沙坦、厄贝沙坦、替米沙坦、坎地沙坦和奥美沙坦为待评价药物，参考泰国学者提出的ISafE法，采用文献检索、查阅说明书和／或半定量评分法，对每种药物的信息量（I）、安全性（S）、用药便捷性（af）和有效性（E）等4个指标赋值。各项指标的权重及赋值方法经征求我国临床医学、药学和流行病学专家的意见确定，安全性和有效性权重各40％，信息量与用药便捷性权重各10％。计算每种药物的ISafE得分，以每日用药费用与ISafE得分的比值作为基本药物价格指数（EMCI）并进行排名，EMCI值越小，越值得推荐。结果6种待评价药物的信息量赋值由高到低依次为氯沙坦、缬沙坦、替米沙坦、厄贝沙坦、坎地沙坦、奥美沙坦；有效性依次为奥美沙坦、替米沙坦、缬沙坦、厄贝沙坦、坎地沙坦、氯沙坦；安全性依次为为替米沙坦、奥美沙坦、厄贝沙坦、坎地沙坦、缬沙坦、氯沙坦；用药便捷性赋值相同；ISafE分值从高至低依次为替米沙坦、奥美沙坦、厄贝沙坦、缬沙坦、氯沙坦和坎地沙坦。国产药中缬沙坦EMCI值最小，与该药为纳入我国现行基本药物目录的唯一ARB类药物吻合，合资药中以替米沙坦EMCI值最小。结论经优化和本土化后的ISafE法具有信息客观、操作性强的特点，可为我国基本药物遴选方法的进一步完善提供参考。Objective To investigate the method of essential medicines selection in China. The angiotensin II receptor antagonist （ARB） drugs were taken as templet. Methods ARB drugs recommended by ＂ Guidelines for the prevention and control of hypertension in China 2010＂ including losartan, valsartan, irbesartan, telmisartan, eandesartan and olmesartan were included as the intended evaluating drugs. Each drug＇s information （I）, safety （S）, administration restriction and frequency of drug administration （af）, and efficacy （E） scores were evaluated respectively and were put together as ISafE. The weight and evaluation of every index were confirmed by the suggestions of specialists in clinical medicine, pharmacy, and epidemiology in China. The weight of safety and efficacy were 40%, respectively, and the information and administration restriction and frequency of drug administration were 10%, respectively. The score of each drug＇s ISafE was calculated. The ratio of each drug＇s daily medication costs to score of ISafE was the essential medicine cost index （EMCI）. The EMCI of each drug was ranked according to the value. The lower the drug＇s EMCI value, the drug would be more likely to be recommended. Results The scores of information in the 6 ARB drugs from high to low in turn were losartan, valsartan, telmisartan, irbesartan, candesartan, and olmesartan. The scores of efficacy in the 6 ARB drugs from high to low in turn were olmesartan, telmisartan, valsartan, irhesartan, eandesartan, and losartan. The scores of safety in the 6 ARB drugs from high to low in turn were telmisartan, olmesartan, irbesartan, eandesartan, valsartan, and losartan. The 6 ARB drugs had the same scores in af value. The scores of ISafE in the 6 ARB drugs from high to low in turn were telmisartan, olmesartan, irbesartan, valsartan, losartan, and candesartan. The EMCI value of valsartan was the lowest among the domestic ARB drugs. The above-mentioned result was consistent with that of valsartan, which was the only ARB dru

关 键 词：循证医学 经济学 药学 血管紧张素Ⅱ2型受体拮抗剂 

分 类 号：R544.1[医药卫生—心血管疾病]