治疗急性缺血性脑卒中的3种创新药经济性、可及性对比OA北大核心CSTPCD
Comparison of the economic and accessibility of three innovative drugs in the treatment of acute ischemic stroke
目的 对比3种脑细胞保护创新药(注射用尤瑞克林、依达拉奉右莰醇注射用浓溶液、丁苯酞氯化钠注射液)治疗急性缺血性脑卒中的经济性、可及性,为医疗卫生资源的合理配置提供参考依据.方法 对于经济性,搭建决策树模型,从中国医疗卫生体系角度进行成本-效用分析.对于可及性,通过医院调研、文献检索等方式获取数据,描述3种药品在上海、浙江、江苏地区的可获得性与可负担性.结果 经济性方面,使用注射用尤瑞克林、依达拉奉右莰醇注射用浓溶液、丁苯酞氯化钠注射液在90 d内的总直接医疗成本分别为19514.68元、19575.47元和20264.07元,效用分别为0.1746 QALYs、0.1822 QALYs和0.1799 QALYs.使用依达拉奉右莰醇注射用浓溶液相较于使用注射用尤瑞克林,增量成本效果比为8010.15元/QALY,＜1倍人均国内生产总值,成本效用更优;相较于丁苯酞氯化钠注射液,依达拉奉右莰醇注射用浓溶液成本更低、效用更高,≥3倍人均国内生产总值,不具有经济性.敏感性分析显示研究结果稳健.在上海、浙江、江苏地区,注射用尤瑞克林、依达拉奉右莰醇注射用浓溶液、丁苯酞氯化钠注射液的医院平均配备率分别为59.8%、84.4%、95.9%,地区间差异无统计学意义.3种药品在90 d内的总治疗费用占平均家庭年收入的10.6%～15.6%,不会造成灾难性卫生支出;其中,使用注射用尤瑞克林的成本最低.结论 在3种脑细胞保护创新药中,注射用尤瑞克林的成本最低,依达拉奉右莰醇注射用浓溶液成本效用最优,丁苯酞氯化钠注射液在上海、浙江、江苏地区的可获得性最高.
Objective To compare the economic aspects and accessibility of three innovative brain cytoprotective drugs(Urinary Kallidinogenase Injection,Edaravone dexborneol Injection,and dl-3-n-butylphthalide Injection)in acute ischemic stroke,providing a basis for the rational allocation of healthcare resources.Methods For economic evaluation,a decision-tree model was constructed and a cost-utility analysis was performed from the perspective of China's healthcare system.For accessibility,data were collected through hospital surveys and literature reviews to describe the availability and affordability of the three drugs in Jiangsu,Zhejiang and Shanghai.Results In terms of cost-effectiveness,the total direct medical costs within 90 days for Urinary Kallidinogenase Injection,Edaravone dexborneol Injection,and dl-3-n-butylphthalide Injection were ¥19514.68,¥19575.47,and ¥20264.07,respectively,with corresponding utilities of 0.1746 QALYs,0.1822 QALYs,and 0.1799 QALYs.The use of Edaravone dexborneol Injection compared to Urinary Kallidinogenase Injection resulted in an incremental cost-effectiveness ratio of ¥8010.15/QALY,which is less than the average GDP per capita,indicating better cost-effectiveness.Compared to dl-3-n-butylphthalide Injection,Edaravone dexborneol Injection was more cost-effective and had higher utility.Sensitivity analysis showed that results are robust.The average hospital availability rates for Urinary Kallidinogenase Injection,Edaravone dexborneol Injection,and dl-3-n-butylphthalide Injection were 59.8%,84.4%,and 95.9%in Shanghai,Zhejiang and Jiangsu,respectively,with no statistically significant differences between regions.The total treatment costs of the three drugs over 90 days accounted for 10.6%to 15.6%of the average family annual income,not resulting in catastrophic health expenditure.Among these,Urinary Kallidinogenase Injection had the lowest cost.Conclusions Among the three innovative brain cytoprotective therapies,Urinary Kallidinogenase Injection has the lowest cost,while Edaravone dexborneol Injection is the most cost-effective.Dl-3-n-butylphthalide Injection has the highest availability in Shanghai,Zhejiang and Jiangsu.
蔡彩平;丁海霞
南京医科大学,江苏 南京 210000南京医科大学第一附属医院(江苏省人民医院),江苏 南京 210000
药学
脑细胞保护脑卒中药物经济学可及性
brain cytoprotectionstrokepharmacoeconomicsaccessibility
《健康发展与政策研究》 2024 (4)
331-338,344,9
江苏省医院协会医院管理创新专项研究课题(JSYGY-2021-JY20)
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