基于真实世界的治疗耐碳青霉烯病原菌抗菌药物方案的药物经济学评价OA

Objective To evaluate the economic of meropenmen versus tigecycline(combined with meropenem)for the treatment of carbapenem resistant organism(CRO)from the health system perspective.Methods The subjects were hospitalized patients diagnosed with CRO infection in Qinghai Provincial People's Hospital from June 2016 to July 2020 who were treated with meropenem or tigecycline combined with meropenem as antimicrobials.According to its anti-infection regimen,the patients were divided into meropenem(Beconol)(group A)in 38 cases,meropenem(Mepein)(group B)in 7 cases,Tigecycline(Tiantil)combined with meropenem(group C)in 10 cases,and Tigecycline(Tague)combined with meropenem(group D)in 28 cases.A 14-day decision tree model was established to evaluate the economy of the four treatment schemes according to the clinical data of patients.Results The expected costs of group A,B,C and D were 13 850.34 yuan,13 547.43 yuan,16 233.60 yuan and 25 495.72 yuan,respectively.The effective rates of the four groups were 87.50%,42.90%,81.80%and 88.50%,respectively.The effective rate of group B was lower than that of the other three groups,and there was a significant different in the effective rate(P<0.05).The bacterial clearance rates of the four groups were 45.00%,14.30%,18.20%and 57.70%,respectively.The clearance rate of group B and group C was lower than the other two groups,and there was no significant difference in the clearance rates(P>0.05).The QALYs of each group were 6.755×10-3、9.917×10-3、9.496×10-3 和5.504×10-3,respectively.The incremental cost-effectiveness ratio(ICER)shows,A group has economic advantage versus the other three groups.The incremental cost-utility ratio(ICUR)shows,B group was the absolute dominant regimen.Conclusion Meropenem has economic advantage versus in the antimicrobial treatment of CRO.