药物经济学视角下的剂型比较—策略探索与实证案例OA

Objective To explore the effect of different dosage forms of the same drug on its economy.Methods This study reviews typical pharmacoeconomic literature that compares different formulations of the same drug,summarizing their main research characteristics and highlighting the essential methodological considerations for conducting such phamacoeconomic research.To empirically validate these methodological points,this article employs a minimal cost analysis of omadacycline in the treatment of adult community-acquired bacterial pneumonia(CABP)as an example.It compares the costs of sequential intravenous-to-oral therapy versus full-course intravenous therapy with omadacycline,quantitatively demonstrating the economic benefits of introducing an oral formulation for the treatment of CABP with omadacycline.Results This study selected six representative pharmacoeconomic evaluation studies comparing oral formulations of the same drug to other formulations.These studies originate from five countries and cover various disease areas.The primary methods used were cost-effectiveness analysis,cost-utility analysis,or cost-minimization analysis.Additionally,three studies employed decision analysis models.The comprehensive review illustrated that treatment regimens involving intravenous injection formulation incurred higher medical management costs and indirect costs compared to exclusive utilization of oral formulation throughout the treatment.The empirical pharmacoeconomic study of omadacycline showed that adopting a sequential intravenous-to-oral treatment approach resulted in a total savings of 876.42 RMB (4 730.98 RMB vs. 5 607.40 RMB) when compared to full-course intravenous treatment. The cost savings in medication amounted to 30.42 RMB (3 032.98 RMB vs. 3 063.40 RMB),while the savings in non-drug inpatient costs were 846.00 RMB (1 698.00 RMB vs. 2 544.00 RMB). The primary cost difference originated from direct medical costs excluding drug expenditures. One-way sensitivity analysis indicated that the duration of hospital stay had the most significant impact on the economics the two formulations of omadacycline. Conclusion In the pharmacoeconomic evaluation of drugs with different dosage forms,the selection of different research perspectives,whether medication compliance is considered,and which research hypothesis is adopted will have a great impact on the results.