两种中等强度他汀类药物方案治疗高脂血症的成本-效果分析  

Cost-effectiveness Analysis of 2 Kinds of Moderate Intensity Statins Plan in the Treatment of Hyperlipidemia

作　　者：郭胜红[1] 汪延安 孙文武[1] 万书平[1] 孙治华[1] 杨广龙[1] 朱丽华[2] 

机构地区：[1]天门市第一人民医院药剂科,湖北天门431700 [2]武汉大学人民医院心血管内科,武汉430060

出　　处：《中国药房》2017年第26期3610-3613,共4页China Pharmacy

基　　金：国家自然科学基金资助项目(No.81370365)

摘　　要：目的:探讨10 mg/d瑞舒伐他汀和20 mg/d阿托伐他汀治疗高脂血症(HLP)的有效性和经济性。方法:回顾性收集2015年3月-2016年2月天门市第一人民医院门诊收治的180例确诊为HLP的患者资料,根据治疗方案不同分为A、B组,各90例。A组患者给予阿托伐他汀钙片20 mg,qd;B组患者给予瑞舒伐他汀钙片10 mg,qd。两组患者疗程均为8周。比较两组患者治疗前后的血脂指标水平和治疗后的降脂疗效、血脂达标率及不良反应发生情况,并运用成本-效果分析法进行经济学评价。结果:治疗前,两组患者的血脂指标水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的总胆固醇和低密度脂蛋白胆固醇水平均明显低于治疗前,且B组水平明显低于A组,差异均有统计学意义(P<0.05);B组患者的降脂总有效率(97.78%)显著高于A组(86.67%),血脂达标率(66.67%)也显著高于A组(51.11%),差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。A组和B组方案的成本分别为488.32、436.24元,成本-效果比分别为5.63、4.46,增量成本-效果比为-4.69,B组方案更具有成本-效果优势。敏感度分析支持成本-效果分析结果。结论:从短期疗效上分析,10 mg/d瑞舒伐他汀方案较20 mg/d阿托伐他汀方案的降脂效果更好,更具有成本-效果优势,且二者安全性相当。OBJECTIVE： To investigate the effectiveness and economics of 10 mg/d rosuvastatin and 20 mg/d atorvastatin in the treatment of hyperlipidemia （HLP）. METHODS： The information of 180 HLP patients selected from Tianmen Municipal First People＇s Hospital during Mar. 2015-Feb. 2016 were divided into group A and B according to medication regimen, with 90 cases in each group. Group A was given Atorvastatin calcium tablet 20 mg, qd; group B was given Rosuvastatin calcium tablet 10 mg, qd. Treatment course of 2 groups lasted for 8 weeks. Blood lipid indexes before and after treatment, lipid-lowering efficacy, the rate of qualified blood lipid and the occurrence of ADR after treatment were compared between 2 groups. Cost-effectiveness analysis was adopted for economic evaluation. RESULTS： Before treatment, there was no statistical significance in the levels of blood lipid in- dexes between 2 groups （P〉0.05）. After treatment, TC and LDL-C levels of 2 groups were significantly lower than before treat- ment, and those of group B were significantly lower than those of group A, with statistical significance （P〈0.05）. Total response rate of lipid-lowering in group B （97.78%） was significantly higher than group A （86.67%）, and the rate of qualified blood lipid （66.67%） was also significantly higher than group A （51.11% ）, with statistical significance （P〈0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P〉0.05）. The costs of group A and B were 488.32, 436.24 yuan, and cost-effectiveness ratios were 5.63, 4.46; incremental cost-effectiveness ratio was --4.69. The plan of group B had cost-effective- ness advantage. The results of cost-effectiveness analysis were supported by sensitivity analysis. CONCLUSIONS： In the view of short-term efficacy, 10 mg/d rosuvastatin plan is better than 20 mg/d atorvastatin plan in lowering lipid and has cost-effectiveness advantage, and both have similar safety.

关 键 词：阿托伐他汀:瑞舒伐他汀 高脂血症 成本-效果分析 药物经济学 中等强度他汀类药物方案 

分 类 号：R956[医药卫生—药学]