苏北农村高血压高危患者降压药物的成本-效果分析  

Cost-effectiveness analysis of anti-hypertensive drugs in high-risk hypertensive patients in rural areas of northern Jiangsu Province

作　　者：乔适雨 赵云松 陈欣 汪嘉琦 向全永[4] QIAO Shi-yu;ZHAO Yun-song;CHEN Xin;WANG Jia-qi;XIANG Quan-yong(Sihong Hospital,Jiangsu Suqian 223900,China;不详)

机构地区：[1]泗洪医院(原泗洪县人民医院),江苏宿迁223900 [2]南京医科大学公共卫生学院 [3]东南大学公共卫生学院 [4]江苏省疾病预防控制中心

出　　处：《江苏预防医学》2022年第2期132-134,139,共4页Jiangsu Journal of Preventive Medicine

基　　金：国家科技支撑计划(2011BAI11B01);卫生部卫生行业科研专项(200902001)。

摘　　要：目的掌握苏北农村高血压高危患者降压药物的用药成本和血压控制率的成本-效果。方法按照分层随机抽样的原则,从江苏省泗洪县的12个村筛查入选高血压高危患者3108人,调查其1年的高血压用药情况及血压控制情况。采用成本-效果比(cost-effectiveness ratio,CER)和增量成本效果比(incremental cost-effectiveness ratio,ICER)评价不同治疗方案的高血压高危患者药物治疗效果。结果高血压高危患者的8种治疗方案中,利尿剂+钙离子通道阻滞剂(CCB)类治疗组血压控制率最高(65.48%),血管紧张素转化酶抑制剂(ACEI)+复方制剂治疗组控制率最低(46.79%),各组间血压控制率差异有统计学意义(χ^(2)=30.12,P<0.01)。单用CCB患者年人均用药成本最高(325.28元),单用ACEI的最低(153.19元),各组间差异有统计学意义(F=15.43,P<0.01)。成本效果比(CER)最低为单用利尿剂(2.68),其次是CCB+ACEI(2.84);单用利尿剂的增量成本效果比(ICER)值为4.96,而CCB+ACEI的仅为3.32。结论在江苏省苏北农村地区推荐成本-效果较优的3种高血压患者药物治疗方案,即单用利尿剂、CCB+ACEI、利尿剂+CCB,尤其是CCB+ACEI的ICER最佳。Objective To investigate the cost-effectiveness of antihypertensive drugs and blood pressure control rate in high-risk hypertension patients in rural areas of northern Jiangsu Province.Methods According to the principle of stratified random sampling,12 villages were selected and 3108 high-risk hypertensive patients were recruited to investigate their anti-hypertensive medication and blood pressure control status within 1 year.Cost-effectiveness ratio(CER)and incremental cost-effectiveness ratio(ICER)were used to evaluate the effect of different drug treatment programs for high-risk patients with hypertension.Results Among the 8 treatment programs for high-risk patients with hypertension,the highest blood pressure control rate(65.48%)was found in the diuretic+CCB treatment group and the lowest(46.79%)in the ACEI+compounding treatment group,the difference among control rates of different treatment groups was statistically significant(χ^(2)=30.12,P<0.01).The annual per capita medication cost was the highest in the single use of CCB treatment group(325.28 yuan)and lowest in the single use of ACEI treatment group(153.19 yuan),the difference was statistically significant among different treatment groups(F=15.43,P<0.01).The lowest CER was found in the single use of diuretics treatment group(2.68),followed by CCB+ACEI group(2.84);the ICER value was 4.96 in the single use of diuretic group and only 3.32 in the CCB+ACEI treatment group.Conclusion In the rural areas of northern Jiangsu Province,three high cost-effective drug treatment programs for hypertension patients were recommended as single use of diuretics,CCB+ACEI and diuretics+CCB;among which CCB+ACEI treatment program has the optimal incremental cost-effectiveness.

关 键 词：高血压 降压药物 成本-效果分析 

分 类 号：R544.1[医药卫生—心血管疾病]