基于决策树模型对国产与原研注射用盐酸万古霉素治疗MRSA感染的成本-效果分析  

Cost-effectiveness Analysis of Domestic and Original Injection Vancomycin Hydrochloride for the Treatment of MRSA Infection based on Decision Tree Model

作　　者：梁虹艺 叶嘉盛 季波 袁进 万宁 LIANG Hongyi;YE Jiasheng;JI Bo;YUAN Jin;WAN Ning(Department of Clinical Pharmacy,General Hospital of Southern Theatre Command,Guangzhou,Guangdong 510010,China)

机构地区：[1]中国人民解放军南部战区总医院临床药学科,广东广州510010

出　　处：《今日药学》2021年第9期702-707,712,共7页Pharmacy Today

基　　金：广东省自然科学基金-面上项目(2021A1515012251)。

摘　　要：目的开展国产和原研注射用盐酸万古霉素治疗甲氧西林耐药金黄色葡萄球菌(MRSA)感染的药物经济学评价,为临床选药提供参考依据,促进合理用药。方法有效率通过课题组前期已发表的《基于PSM法的真实世界中国产与原研注射用盐酸万古霉素疗效和安全性一致性评价的队列研究》获得,筛选明确MRSA感染的90例患者,其中来可信组23例,稳可信组67例。成本只计直接医疗成本,数据来自广州市某三级医院住院患者病例资料。采用决策树模型对国产组和原研组注射用盐酸万古霉素进行成本效果分析,模型结果的稳健性通过单因素敏感性分析来评估。结果来可信组有效率为86.9%,无不良反应发生;稳可信组有效率为85.1%,发生1例不良反应。两组有效率差异无统计学意义(P>0.05)。来可信组期望成本为11 256.47元,稳可信组期望成本为11 723.92元。每使1例患者临床获益,来可信需要的增量药物治疗成本为-25 969.47元。敏感性分析结果显示模型稳健性好。结论来可信比稳可信在治疗MRSA感染时更具有经济性。OBJECTIVE To carry out the pharmacoeconomic evaluation of domestic and original injection of vancomycin hydrochloride for the treatment of methicillin-resistant staphylococcus aureus(MRSA) infection, and to provide evidence for doctors to choose drugs and promote reasonable medication. METHODS Response rate was obtained from the previously published study entitled “Cohort study on the efficacy and safety of domestic and original vancomycin hydrochloride for injection in real-world based on PSM method”.A total of 90 patients with clear MRSA infection using generic vancomycin(Laikexin group, 23 cases)or original vancomycin(Vancocin group, 67 cases)were included.Only the direct medical cost was recorded in the current study.The data was collected from inpatients in a tertiary hospital in Guangzhou.The decision tree model was used for cost effectiveness analysis of vancomycin hydrochloride in the domestic group and the original research group.The robustness of the model was verified by single factor sensitivity analysis. RESULTS There was no significant difference(P>0.05) between two groups.The response rate of Laikexin group was 86.9% with no one adverse reaction occurring.And the response rate of Vancocin group was 85.1% with adverse reaction occurring in 1 case.The excepted cost of Laikexin and Vancocin were 11 256.47 yuan and 11 723.92 yuan, respectively.The cost of Laikexin for each unit of clinical effect was-25 969.47 yuan less than Vancocin.The results of sensitivity analysis indicated that the study results were robust. CONCLUSION Laikexin is more economical than Vancocin in treating MRSA infections.

关 键 词：MRSA 来可信 稳可信 决策树 成本效果 

分 类 号：R969[医药卫生—药理学]