锂盐联合喹硫平与氯氮平应用于双相躁狂发作的药物经济学评价  

Pharmacoeconomics Evaluation of Lithium Combined with Quetiapine versus Clozapine in the Treatment of Maniac Episode of Bipolar Disorder

作　　者：柳杨 梁俊[1,2,3] 夏清荣 解雪峰[4] 陈欢 高文凡[1,2,3] 单锋[1,2,3] Liu Yang;Liang Jun;Xia Qingrong;Xie Xuefeng;Chen Huan;Gao Wenfan;Shan Feng(Affiliated Psychological Hospital of Anhui Medical University,Anhui 230022,China;Department of Mental Pharmacology,Anhui Mental Health Center;Department of Pharmacy,Hefei Fourth People*s Hospital;College of Pharmacy,Anhui Medical University)

机构地区：[1]安徽医科大学附属心理医院,合肥230022 [2]安徽省精神卫生中心精神药理研究室 [3]合肥市第四人民医院药剂科 [4]安徽医科大学药学院

出　　处：《药物流行病学杂志》2021年第9期611-615,共5页Chinese Journal of Pharmacoepidemiology

基　　金：合肥市应用医学研究项目(编号:hwk2018zc017);安徽医科大学校科研基金项目(编号:2019xkj205);合肥市第六周期重点学科项目。

摘　　要：目的:对锂盐联合二代抗精神病药喹硫平与氯氮平的治疗方案做药物经济学评价,为双相躁狂发作患者临床合理用药提供参考。方法:选取2015年1月~2019年10月于安徽某三级精神专科医院就诊的双相躁狂患者的病历资料进行回顾性分析。在综合考虑患者治疗前后贝克-拉范森躁狂量表(BRMS)评分以及不良反应发生情况的基础上,对锂盐联合喹硫平与锂盐联合氯氮平这两种治疗方案进行药物经济学评价。结果:锂盐联合喹硫平组共纳入有效病例88例,锂盐联合氯氮平组纳入病例43例。两组药物治疗的缓解率差异无统计学意义(P>0.05),锂盐联合喹硫平组的不良反应发生率更低。最小成本分析结果显示锂盐联合喹硫平组住院成本低于锂盐联合氯氮平组。敏感性分析结果与基本分析保持一致。结论:锂盐联合氯氮平药物成本低,但是住院总成本显著高于锂盐联合喹硫平组。故锂盐联合喹硫平相对于锂盐联合氯氮平治疗双相情感障碍躁狂发作更具有经济性。Objective:To evaluate the pharmacoeconomics of the treatment regimens of lithium combined with the second generation antipsychotic quetiapine or clozapine, so as to provide evidences for rational clinical drug use for maniac episode of bipolar disorder. Methods:This was a retrospective study collecting clinical data from patients with maniac episode of bipolar disorder who received treatment at a third-level psychiatric hospital in Anhui province from January 2015 to October 2019. Based on comprehensive consideration of the pretreatment and posttreatment Bech-Rafaelsen Mania Rating Scale(BRMS) scores and the occurrence of adverse reactions, cost-effectiveness analysis of two treatment regimens, lithium combined with quetiapine and lithium combined with clozapine. Results: Lithium combined with quetiapine group included a total of 88 valid subjects;lithium combined with clozapine group included a total of 43 valid subjects. There was no significant difference in the remission rate of therapy between the two groups(P>0.05), and the incidence of adverse reactions was lower in the lithium combined with quetiapine group. The result of cost-minimization analysis showed that hospitalization costs were lower in the lithium combined with quetiapine group than in the lithium combined with clozapine group. The results of the sensitivity analysis remained consistent with the basic analysis.Conclusion:Lithium combined with clozapine had a lower cost, but the total hospitalization cost was significantly higher than that of the lithium combined with quetiapine group. Therefore, lithium combined with quetiapine is more economical than lithium combined with clozapine in the treatment of manic episodes in bipolar disorder.

关 键 词：锂盐 喹硫平 氯氮平 双相情感障碍 躁狂发作 药物经济学 最小成本分析 

分 类 号：F407.7[经济管理—产业经济]