帕拉米韦治疗儿童流行性感冒的循证药物经济学评价  

Evidence-Based Pharmacoeconomic Evaluation of Peramivir in the Treatment of Influenza in Children

作　　者：黄光亮 闫宇驰 何文娟[1] 赵晓娟[1] 赵永红[1] 刘秀菊[1] Huang Guangliang;Yan Yuchi;He Wenjuan;Zhao Xiaojuan;Zhao Yonghong;Liu Xiuju(The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Southern Medical University,Guangzhou 510515,China)

机构地区：[1]河北医科大学第二医院,石家庄050000 [2]南方医科大学,广州510515

出　　处：《儿科药学杂志》2022年第2期8-12,共5页Journal of Pediatric Pharmacy

基　　金：河北省医学科学研究课题计划项目,编号20200978。

摘　　要：目的:探讨静脉滴注帕拉米韦与口服奥司他韦在治疗儿童流行性感冒的有效性、安全性和经济性差异。方法:计算机检索中国知网、中国生物医学文献数据库、维普、万方数据库、PubMed、the Cochrane Library、Web of Science等中英文数据库。根据纳入标准和排除标准,筛选符合要求的帕拉米韦对比奥司他韦治疗儿童流行性感冒的随机对照试验,文献质量评价根据Cochrane协作网提供的质量评估标准进行,终点观测指标由RevMan 5.4软件进行Meta分析,使用成本-效果分析法对所得结果进行经济学评价。结果:临床有效率和不良事件发生率两组比较差异均有统计学意义(RR=1.11,95%CI 1.07~1.15,Z=5.14,P<0.000 01;RR=0.66,95%CI 0.47~0.94,P=0.02)。在经济学方面,以帕拉米韦用药时间和不同儿童体质量分别组合得出不同的增量成本效果比(ICER)值,帕拉米韦单次用药的ICER值分别为体质量≤15 kg, ICER=3.81;体质量>15~23 kg, ICER=5.72;体质量>23~40 kg, ICER=1.15;体质量>40 kg, ICER=-3.41。结论:在治疗儿童流行性感冒的过程中,帕拉米韦相比于奥司他韦在有效率和不良事件发生率上均占有优势;在经济学方面,奥司他韦普遍占有优势,帕拉米韦仅在单次用药时具有成本-效果比优势。Objective: To probe into the differences for efficacy, safety and economy of intravenous peramivir and oral oseltamivir in the treatment of influenza in children. Methods: CNKI, CBM, VIP, Wanfang, PubMed, the Cochrane Library and Web of Science database were retrieved. According to the inclusion and exclusion criteria, the eligible randomized controlled trials of peramivir versus oseltamivir in the treatment of influenza in children were screened. Literature quality was evaluated according to the quality assessment criteria provided by the Cochrane system evaluation standard. The endpoint observation indicators were obtained by Meta analysis with RevMan 5.4 software, and the results were evaluated economically by cost-effectiveness analysis. Results: There were significant differences between two groups in clinical effective rate and incidence of adverse events(RR=1.11, 95%CI from 1.07 to 1.15, Z=5.14, P<0.000,01;RR=0.66, 95%CI from 0.47 to 0.94, P=0.02). In terms of economics, different incremental cost-effectiveness ratio(ICER) values were derived by combining the duration of paramivir dosing and different body mass in children, respectively. The ICER values for single dose of peramivir were body mass ≤15 kg, ICER=3.81;body mass >15 to 23 kg, ICER=5.72;body mass >23 to 40 kg, ICER=1.15;body mass >40 kg, ICER=-3.41. Conclusion: Compared with oseltamivir, peramivir has advantages in the effective rate and incidence of adverse events in the treatment of influenza in children;in terms of economics, oseltamivir generally held an advantage, with paramivir having a cost-effectiveness ratio advantage only at single dose.

关 键 词：帕拉米韦 奥司他韦 儿童 流行性感冒 META分析 循证药物经济学 

分 类 号：R969.3[医药卫生—药理学]