中国全科医学2016，Vol.19Issue(1)：92-95,4.DOI:10.3969/j.issn.1007-9572.2016.01.019
高血压社区规范化管理中常用抗高血压药物的成本-效果研究
Cost-effectiveness of Common Antihypertensive Drugs in Community Standardized Management of Hypertension
摘要
Abstract
Objective To evaluate the cost -effectiveness of five common antihypertensive drugs in community standardized management of hypertension .Methods According to administrative regional distribution and economic development level, 220 community health service centers (stations) and township health centers from 15 provinces/autonomous regions in the east, middle and west regions in China were selected .Using the community standardized hypertension management plan in China Guideline for Hypertension Prevention and Control (2009 grassroot version), we conducted training on the health workers in these included medical settings , and the trainees were required to undertaken one -year standardized management on hypertensive patients.There were all together 43 039 patients who had complete data and received standardized management for more than 1 year, and 10 456 patients were treated with monotherapy on hypertension and didn′t change therapeutic regimen during follow up period ( dosage adjustment was allowed ) .There were 10 277 patients who were administrated with five major antihypertensive drugs, including diuretic , calcium antagnists , β-receptor blocker , angiotensin Ⅱreceptor antagonists ( ARB ) and angiotensin converting enzyme inhibitor ( ACEI) .According to gender , age, and risk stratification and a match ratio of 1:6:1:1:3, a total of 7 032 patients were included as study subjects .The trained health workers filled out uniform medical records , and we recorded sociodemographic characteristics , complications, hypertension grade, risk grade and the daily dosage , scale, price and actual number of days of drug administration .Cost -effectiveness analytical method was used to evaluate the cost -effectiveness of antihypertensive drug .Results Among 7 032 patients included in the cost -effectiveness analysis , the annual cost per person was 219.0 (553.0) yuan, the drop rate of systolic pressure was (10.6 ±8.6)%, and the cost -effectiveness ratio was 20.7; the drop rate of diastolic pressure was (10.0 ±9.6)%, cost-effectiveness ratio was 21.9; the control rate of blood pressure was 75.1% (5 281/7 032), cost-effectiveness ratio was 2.9.There were significant differences among the five antihypertensive drugs in annual cost per person (P<0.05) .The five major antihypertensive drugs were significantly different in the drop rate of systolic pressure , the drop rate of diastolic pressure and the control rate of blood pressure ( P<0.05 ) .When taking the drop rate of systolic pressure , the drop rate of diastolic pressure and the control rate of blood pressure as effectiveness indexes, the cost-effectiveness ratios of ACEI were 5.0, 5.3 and 0.9 and the cost-effectiveness ratios of diuretic were 19.0, 18.6 and 2.5, both lower than those of β-receptor blocker, calcium antagnists and ARB.Conclusion In community standardized management of hypertension , ACEI and diuretic have better cost -effectiveness than other drugs .关键词
高血压/规范化管理/抗高血压药物/成本-效果/社区Key words
Hypertension/Standardized management/Antihypertensive drug/Cost-effectiveness/Community分类
医药卫生引用本文复制引用
冯芮华,王增武,王小万,李建,王馨,陈祚,崔月颖,朱曼璐..高血压社区规范化管理中常用抗高血压药物的成本-效果研究[J].中国全科医学,2016,19(1):92-95,4.基金项目
卫生行业科研专项项目(200902001) （200902001）
中央级公益性科研院所基本科研业务费(15R0103) （15R0103）
