标准二联止吐方案预防中致吐风险药物所致恶心呕吐的成本-效果分析  

Cost-effectiveness analysis of standard two-drug combination antiemetic regimen for preventing nausea and vomiting caused by drugs with moderate risk of vomiting

作　　者：朱良荣 杨慧慧 林珍珍 潘佳玲 潘红巧 ZHU Liang-rong;YANG Hui-hui;LIN Zhen-zhen;PAN Jia-ling;PAN Hong-qiao(Wenling Hospital of Traditional Chinese Medicine,Wenling 317500,China)

机构地区：[1]温岭市中医院,浙江温岭317500

出　　处：《中国药物应用与监测》2021年第3期150-154,共5页Chinese Journal of Drug Application and Monitoring

基　　金：温岭市科技计划项目(2019S0010004)。

摘　　要：目的:对预防中致吐风险药物所致恶心呕吐的标准二联止吐方案进行经济学评价。方法:回顾性分析我院2018-2019年采用标准二联止吐方案预防中致吐风险药物所致恶心呕吐的住院患者资料,采用决策树模型,对使用昂丹司琼8 mg+地塞米松5 mg(A组)、格拉司琼3 mg+地塞米松5 mg(B组)、托烷司琼5 mg+地塞米松5 mg(C组)和帕洛诺司琼0.25 mg+地塞米松5 mg(D组)四组患者的临床结局及成本参数等进行统计分析。结果:共纳入住院病历316份,预防有效率D组最高(94.20%),A组最低(81.50%);期望成本-效果比D组最高(357.40),B组最低(172.34);当患者支付意愿值为<2390.74元、2390.74~2444.58元或>2444.58元时,最佳选择方案分别为B组、C组、D组,同时也需结合成本阈值综合判断。敏感性分析提示此结果稳定可靠。结论:临床可以根据患者支付意愿及DRGs点数付费等情况选择最佳治疗方案,保障患者用药的安全性、有效性和经济性。Objective:To evaluate the economics of standard two-drug combination antiemetic regimen for preventing nausea and vomiting caused by vomiting risk drugs.Methods:Data of hospitalized patients using standard two-drug combination antiemetic regimen to prevent nausea and vomiting caused by drugs with moderate risk of vomiting in our hospital from 2018 to 2019 were retrospectively collected.Decision tree model was used to analyze the clinical outcomes and cost parameters of four groups of patients treated with ondansetron 8 mg+dexamethasone 5 mg(group A),granisetron 3 mg+dexamethasone 5 mg(group B),tropisetron 5 mg+dexamethasone 5 mg(group C)and palonosetron 0.25 mg+dexamethasone 5 mg(group D).Results:A total of 316 hospital records were included in this study.The prevention effective rate of group D(94.20%)was the highest while that of group A(81.50%)was the lowest.The expected cost-effectiveness ratio was the highest in group D(357.40)and the lowest in group B(172.34).If the willingness to pay value of the patients was less than 2390.74 yuan,2390.74-2444.58 yuan and more than 2444.58 yuan,the best option was group B,group C and group D respectively,which should be comprehensive analyzed in combination with cost threshold.Results of sensitivity analysis indicated that the results were stable and reliable.Conclusion:The best treatment plan could be selected according to the patient's willingness to pay and DRGs points payment to ensure the safety,effectiveness and economy of drug use.

关 键 词：决策树 二联止吐 5-HT3受体拮抗剂 中致吐风险药物 成本-效果分析 

分 类 号：R956[医药卫生—药学] R969.4