上海市血管紧张素转化酶抑制剂和血管紧张素受体拮抗剂治疗原发性高血压的经济学评价研究  

Research on the Economic Evaluation of Applying Angiotensin-converting Enzyme Inhibitor and Angiotensin Receptor Blocker in the Treatment of Essential Hypertension

作　　者：何江江[1,2] 胡善联[1,2] 汤真清 祝菁菁[2] 汤庆伟 徐维维[2] 王吉龙 刘月星 

机构地区：[1]上海市医学科学技术情报研究所上海市卫生发展研究中心,上海200040 [2]复旦大学公共卫生学院,上海200032 [3]上海市医药集中招标采购事务管理所,上海200081 [4]上海市嘉定区卫生事务管理中心,上海201080 [5]上海市闸北区卫生科技与信息中心,上海200070

出　　处：《中国卫生经济》2016年第7期80-84,共5页Chinese Health Economics

摘　　要：目的：基于上海市ACEI和ARB两类药品的采购费用分析情况，结合典型地区的经济学评价结果和数据模拟的预算影响分析，以明确两者相对的经济学价值，为临床降压药物的合理有效使用提供数据支持。方法：选择一个社区卫生服务中心和一定区域范围的医疗机构作为典型抽样机构，分析ACEI或ARB单药治疗轻中度原发性高血压患者的直接医疗费用。分析指标包括人均年治疗总费用和次均治疗费用等。选择成本最小化分析方法开展药物经济学评价研究。基于上述研究结果和药品招标采购平台数据库。模拟在完全规范高血压管理情况下比较ACEI和ARB类药物的总费用。并进行预算影响分析。结果：从卫生服务提供者的角度考虑，基于典型地区直接医疗费用数据分析结果，ACEI类药品在次均治疗费用上相对ARB类药品具有成本优势；通过预算影响分析，在假定完全规范高血压管理情况下，ACEI类药品对ARB类药品的替换具有节约费用的作用，若完全替代。可为上海医保支出节约1．5～2．4亿元。结论：从医保基金的高效使用以及病人的经济负担角度，建议各级医疗机构优先使用ACH类药品。Objective： Based on the purchasing cosl analysis of two kinds of drugs （ACEI and ARB） in Shanghai, economics evaluation results of typical areas and budget impact analysis of data simulation were combined to ensure their relative economic value and to provide data support for reasonable and effective clinical usage of antihypertensive drugs. Methods： Selecting a community health service center and medical institutions in a certain area as a typical sample size, it analyzed direct medical costs of ACEI or ARB monotherapy in patients with mild to moderate essential hypertension, in whieh the analysis indicators inchaled per capita yearly total health care costs and treatment costs per visit. Cost minimization analysis was applied on the pharmacoeconomie evaluation research. Based on the ＇above findings and database of pharmaceutical bidding and purchasing platform, it simulated to compare the total costs of ACEI and ARB drugs in complete specific management of hypertension, and carry out budget impact analysis. Results： From the perspective of health service providers, based on the data analysis result of the direct medical costs in a typical region, ACEI had a cost advantage over ARB in the average drug expense of each treatment. With the budget impact analysis, replacing ARB with ACEI could save cost in complete specific management of hypertension. If fully replacing ARB with ACE1, Shanghai medical spending could save 150-240 million yuan. Conclusion： From the perspectives of the efficient use of the health insurance fund and the economie burden for patients, it proposed all medical institutions use ACEI drugs in preference.

关 键 词：血管紧张素转化酶抑制剂 血管紧张素受体拮抗剂 原发性高血压 成本最小法 预算影响分析 上海 

分 类 号：R544.11[医药卫生—心血管疾病]