替诺福韦酯用于成人初治获得性免疫缺陷综合征患者的成本-效果分析  

Cost-effectiveness Analysis of Tenofovir Dipivoxil for Treatment-naive Adult Patients with AIDS

作　　者：王超[1] 郭立杰[1] 董玲[2] 张海丛[3] 张玉君 冯彩霞[1] WANG Chao;GUO Li-jie;DONG Ling;ZHANG Hai-cong;ZHANG Yu-jun;FENG Cai-xia(Department of Pharmacy,the Fifth Hospital of Shijiazhuang,Shijiazhuang 050021,China;Finance Section,the Fifth Hospital of Shijiazhuang,Shijiazhuang 050021,China;Department of Clinical Laboratory,the Fifth Hospital of Shijiazhuang,Shijiazhuang 050021,China)

机构地区：[1]石家庄市第五医院药剂科,石家庄050021 [2]石家庄市第五医院财务科,石家庄050021 [3]石家庄市第五医院检验科,石家庄050021

出　　处：《临床误诊误治》2020年第11期29-34,共6页Clinical Misdiagnosis & Mistherapy

基　　金：2018年石家庄市科学技术研究与发展指导计划(181200943)。

摘　　要：目的观察替诺福韦酯用于成人初治获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者的成本-效果分析结果。方法选取符合纳入及排除标准口服抗病毒药物治疗的AIDS 256例作为研究对象,根据治疗方案不同,将其分为试验组(144例)和对照组(112例)两组,试验组给予富马酸替诺福韦二吡呋酯片+依非韦伦片+拉米夫定片,对照组给予依非韦伦片+齐多拉米双夫定片。观察比较两组一般资料、病毒学指标、免疫学指标、不良反应发生情况、住院情况及治疗成本,并进行成本-效果分析。结果治疗后3、6和12个月,两组人类免疫缺陷病毒(human immunodeficiency virus,HIV)-RNA转阴率比较差异均无统计学意义(P>0.05);治疗前和治疗后3、6、12个月,两组CD4+T淋巴细胞数比较差异均无统计学意义(P>0.05)。不良反应总发生率试验组明显低于对照组,差异具有统计学意义(P<0.05);两组严重不良反应发生率比较差异无统计学意义(P>0.05)。治疗过程中,试验组总住院率低于对照组,两组比较差异具有统计学意义(P<0.05)。试验组检查费用、住院费用和总费用均低于对照组,差异有统计学意义(P<0.05或P<0.01)。成本-效果分析结果显示,试验组成本-效果比低于对照组,增量成本-效果比为-376.63。增量成本效果象限图显示试验组所选取方案为优势方案。结论采用本文两种方案治疗的AIDS患者效果无明显差异。但含替诺福韦酯的试验组不良反应总发生率、总住院率和经济性要优于含齐多夫定的对照组,故对初治成人AIDS患者来说,建议优先使用含替诺福韦酯的治疗方案。Objective To analyze the results of cost-effectiveness analysis of Tenofovir Dipivoxil in the treatment of naive adult patients with aquired immunodeficiency syndrome(AIDS).Methods We included 256 AIDS patients who met the inclusion and exclusion criteria for oral antiviral treatment.The subjects were divided into the experimental group(n=144)and the control group(n=112)depending on their treatment methods.The experimental group was given Tenofovir Disoproxil Fumarate tablets+Efavirenz tablets+Lamivudine tablets,and the control group was given Efavirenz tablets+Zidolamivudine tablets.The general data,virological parameters,immunological parameters,incidence of adverse effects,hospitalizations,and treatment costs between the two groups were examined and compared,and a cost-effectiveness analysis was performed.Results There was no significant difference in the human immunodeficiency virus(HIV)-RNA negative conversion rate between the two groups at 3,6 and 12 months after treatment(P>0.05),nor significant difference in the number of CD4+T lymphocytes between the two groups before treatment and at 3,6,and 12 months after treatment(P>0.05).The total incidence of adverse effects in the experimental group was significantly lower than that in the control group(P<0.05),and there was no significant difference in the incidence of serious adverse effects between the two groups(P>0.05).During the treatment,the total hospitalization rate in the experimental group was significantly lower than that in the control group(P<0.05).The testing costs,hospitalization expenses and total expenses of the experimental group were significantly lower than those of the control group(P<0.05 or P<0.01).The results of cost-effectiveness analysis showed that the cost-effectiveness ratio of the experimental group was lower than that of the control group,and the incremental cost-effectiveness ratio(ICER)was-376.63.The incremental cost-effectiveness quadrant showed that the treatment of the experimental group was the dominated one.Conclusion There w

关 键 词：获得性免疫缺陷综合征 高效联合抗反转录病毒治疗 替诺福韦酯 成本-效果分析 

分 类 号：R512.91[医药卫生—内科学]