德谷门冬双胰岛素治疗预混胰岛素血糖控制不佳2型糖尿病患者的成本-效果分析  

Analysis of cost-effectiveness of Degu Aspartan dual insulin in treatment of type 2 diabetes mellitus patients with poorly controlled premixed insulin

作　　者：吴冬波 张玲[2] 黄钰梅 廖伟玲 李素芬[3] WU Dongbo;ZHANG Ling;HUANG Yumei;LIAO Weiling;LI Sufen(Department of Endocrinology,Liuzhou Municipal Liutie Central Hospital,Liuzhou,Guangxi 545007,China;Department of Clinical Pharmacy,Liuzhou Municipal Liutie Central Hospital,Liuzhou,Guangxi 545007,China;Department of Clinical Laboratory,Liuzhou Municipal Liutie Central Hospital,Liuzhou,Guangxi 545007,China)

机构地区：[1]柳州市柳铁中心医院内分泌科,广西柳州545007 [2]柳州市柳铁中心医院临床药学科,广西柳州545007 [3]柳州市柳铁中心医院检验科,广西柳州545007

出　　处：《医药前沿》2024年第28期8-11,15,共5页Journal of Frontiers of Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-B20221497)。

摘　　要：目的:分析德谷门冬双胰岛素治疗预混胰岛素血糖控制不佳2型糖尿病(T2DM)患者的成本-效果。方法:选取2022年7月—2023年6月柳州市柳铁中心医院经预混胰岛素治疗后血糖控制不佳的T2DM患者80例,采用随机数字表法分为对照组和观察组各40例。对照组采用门冬胰岛素联合地特胰岛素治疗,观察组采用德谷门冬双胰岛素治疗。运用DACE成本-效果模型对两组健康产出、卫生成本展开分析,并联合实施成本-效果分析。结果:治疗后,两组患者空腹血糖、三餐后2 h血糖、糖化血红蛋白水平均低于治疗前(P<0.05);但两组比较差异无统计学意义(P>0.05)。两组低血糖发生率比较差异无统计学意义(P>0.05)。观察组每日胰岛素注射次数、每日胰岛素注射剂量少于对照组(P<0.05)。与对照组相比,观察组可节约总体直接医疗成本18637元,其中胰岛素成本、自我血糖监测(SMBG)试纸成本、针头成本和低血糖治疗成本分别节约10153元、5476元、2537元和471元;且可多获得0.0391质量调整生命年。结论:对预混胰岛素血糖控制效果不佳的T2DM患者采取门冬胰岛素联合地特胰岛素治疗、德谷门冬双胰岛素治疗,两者血糖控制效果无显著差异。后者可降低胰岛素注射次数、胰岛素注射剂量,还能节约胰岛素、SMBG等各项医疗成本,成本-效果良好,药物经济学优势明显,值得临床应用。Objective To analyze the cost-effectiveness of Degu Aspartan dual insulin in type 2 diabetes mellitus(T2DM)patients with poorly controlled premixed insulin.Methods A total of 80 T2DM patients with poor blood glucose control after premixed insulin therapy of Liuzhou Municipal Liutie Central Hospital from July 2022 to June 2023 were selected,and divided into control group(insulin Aspart combined with insulin Detemir therapy,40 cases)and observation group(Degu Aspartan dual insulin therapy,40 cases)by random number table method.The DACE cost-effect model was used to analyze the two groups of health output and health cost,and to jointly implement the cost-effect analysis.Results Post-treatment fasting blood glucose,2 h after three meals and glycosylated hemoglobin levels were all lower in the two groups than the levels before treatment(P<0.05),there was no significant difference between the observation group and the control group(P>0.05).There was no significant difference in the incidence of hypoglycemia between the observation group and the control group(P>0.05).The number of insulin injections perday and daily insulin injection dose in the observation group were less than those in the control group(P<0.05).Compared with the control group,the total direct medical cost in the observation group was saved 18637 yuan,among which the cost savings of insulin,the cost of self-monitoring of blood glucose(SMBG)test paper,the cost of needle and the cost of hypoglycemia treatment were 10153 yuan,5476 yuan,2537 yuan and 471 yuan,respectively.Compared with the control group,the observation group was associated with an improvement of 0.0391 quality-adjusted life years.Conclusions For T2DM patients with poor blood glucose control by premixed insulin,the insulin Aspart combined with insulin Dieter as well as Degu Aspartan dual insulin treatment,show no significant difference in blood glucose control effects between the two groups.The latter can reduce the number and dosage of insulin injections,as well as save various medical cost

关 键 词：德谷门冬双胰岛素 预混胰岛素 血糖控制不佳 2型糖尿病 成本-效果 

分 类 号：R587[医药卫生—内分泌]