三种方案治疗儿童社区获得性肺炎的疗效及药物经济学评价  

Efficacy and Pharmacoeconomic Evaluation on Three Regimens in Treatment of Community-Acquired Pneumonia in Children

作　　者：莫亚玲 张剑霄 赵德运[1] 孟艳[1] 张古英 MO Yaling;ZHANG Jianxiao;ZHAO Deyun;MENG Yan;ZHANG Guying(Dept.of Pharmacy,Children’s Hospital of Hebei Provincial Affiliated to Hebei Medical University,Hebei Shijiazhuang 050030,China;Dept.of Public Health,Children’s Hospital of Hebei Provincial Affiliated to Hebei Medical University,Hebei Shijiazhuang 050030,China)

机构地区：[1]河北医科大学附属河北省儿童医院药剂科,河北石家庄050030 [2]河北医科大学附属河北省儿童医院公共卫生科,河北石家庄050030

出　　处：《中国医院用药评价与分析》2019年第11期1296-1298,1302,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2018河北省医学科学研究重点课题(No.20180641)

摘　　要：目的:基于成本-效果分析和决策树模型,比较三种方案治疗儿童社区获得性肺炎的临床疗效及药物经济学评价。方法:回顾性选取2017年12月至2018年12月河北医科大学附属河北省儿童医院收治的儿童社区获得性肺炎患儿96例,按治疗药物不同分为A组(重组人干扰素α1b注射液雾化剂)31例、B组(脾多肽注射液)25例和C组(头孢呋辛钠序贯疗法)40例。观察三组患者的成本、临床疗效及不良反应,采用成本-效果分析和决策树模型法对三种治疗方案进行药物经济学评价。结果:三组患者直接医疗总成本的差异有统计学意义(P<0.05)。A、B及C组患者的总有效率分别为93.55%(29/31)、92.00%(23/25)及90.00%(36/40),差异无统计学意义(P>0.05)。三组患者均无明显不良反应发生。A组方案成本-效果比(C/E)最小,C组次之,B组最大;以A组作为参考,B组方案增量成本-效果比(ΔC/ΔE)为负数,表明成本增加其疗效降低;C组方案ΔC/ΔE为正数,表明成本降低其疗效降低,故A组方案最具经济性。敏感度分析(成本费用±10%)结果与成本-效果分析结果一致。结论:儿童社区获得性肺炎的三种治疗方案中,重组人干扰素α1b注射液雾化剂更具成本-效果优势,抗菌药物序贯疗法次之,脾多肽注射液不具优势。OBJECTIVE: Based on cost-effectiveness analysis and decision-making tree, the clinical efficacy and pharmacoeconomic evaluation of three regimens in treatment of community-acquired pneumonia(CAP) in children were compared. METHODS: 96 children with CAP admitted into Children’s Hospital of Hebei Provincial Affiliated to Hebei Medical University from Dec. 2017 to Dec. 2018 were retrospectively selected and divided into group A(treated with atomizer of recombinant human interferon α1 b injection, 31 cases), group B(treated with lienal polypeptide injection, 25 cases) and group C(treated with sequential therapy of cefuroxime sodium, 40 cases) according to different therapeutic regimens. The treatment costs, clinical efficacy and adverse drug reactions of three groups were observed, cost-effectiveness analysis and decision-making tree were adopted to conduct pharmacoeconomic evaluation on the three therapeutic regimens. RESULTS: The difference in total direct medical cost among the three groups was statistically significant(P<0.05). The total effective rate of group A, group B and group C were respectively 93.55%(29/31), 92.00%(23/25) and 90.00%(36/40), the difference had no statistical significance(P>0.05). No obvious adverse drug reactions were found in three groups. The cost-effectiveness ratio(C/E) of group A was the smallest, the second was group C and the largest is group B;taking group A as a reference, the incremental cost-effectiveness ratio(ΔC/ΔE) of group B was minus, which indicated that its efficacy declines as the cost increased;the ΔC/ΔE of group C was a positive number, which indicated that its efficacy declines as the cost reduced, therefore, group A is the most economical. The result of sensitivity analysis(cost±10%) was consistent with the result of cost-effectiveness analysis. CONCLUSIONS: In the three regimens in treatment of CAP in children, atomizer of recombinant human interferon α1 b injection has more advantage in cost-effectiveness, followed by sequential therapy of cefuroxime sodiu

关 键 词：儿童社区获得性肺炎 治疗方案 成本-效果 决策树模型 

分 类 号：R974[医药卫生—药品]