3种核苷类似物治疗慢性乙型肝炎的成本-效果分析
Cost-effectiveness analysis of three kinds of nucleoside analogues for chronic hepatitis B
-
摘要: 目的 探讨3种核苷类似物治疗慢性乙型肝炎的经济效果。 方法 将268例患者分成3组,ADV组用阿德福韦酯10 mg,ETV组用恩替卡韦0.5 mg,LdT组用替比夫定600 mg,均为每天1次,疗程均为48周。进行疗效和不良反应观察,应用药物经济学成本-效果分析法进行评价。 结果 在HBV-DNA阴转率方面,ETV组和LdT组好于ADV组(P<0.01);在HBeAg阴转率和ALT复常率方面,3组差异无显著性(P>0.05);3组的不良反应差异无显著性(P>0.05);经济学方面,ADV组、ETV组、LdT组的成本-效果比分别是115.38、156.51、96.98,替比夫定优于阿德福韦酯和恩替卡韦。 结论 替比夫定组为优选方案。Abstract: Objective To investigate economic effects of three kinds of nucleoside analogues in treatment of chronic hepatitis B. Methods 268 cases were divided into three groups, ADV group with adefovir dipivoxil 10mg, ETV group with entecavir 0.5 mg, LdT group with telbivudine 600 mg. All the groups were administered once a day with a course of 48 weeks. Efficacy and adverse reactions were observed. Cost-effectiveness analysis was used. Results ETV group and LdT group were better than ADV group in terms of HBV-DNA negative conversion rate(P<0.01),in HBeAg negative conversion rate and ALT normalization rate, three groups showed no statistically significant differences(P>0.05), The adverse reactions of three groups had no significant difference(P>0.05).The effectiveness ratio of ADV group, ETV group, LdT group was 115.38, 156.51, 96.98 respectively.Telbivudine was superior to adefovir dipivoxil and entecavir in terms of economics. Conclution Telbivudine group was the optimal solution for chronic hepatitis B.
-
Key words:
- chronic hepatitis B /
- adefovir dipivoxil /
- entecavir /
- telbivudine /
- pharmacoeconomics
-
[1] Rehermann B,Nascimbeni M. Immunology of hepatitis B virus and hepatitis C virus infextion[J]. Nat Rev lmmunol,2005,5(3):215. [2] Lu FM, Zhuang H. Management of hepatitis B in China[J].Chin Med J, 2009,122(1): 3. [3] Choe WH, Hong SP, Kim BK, et al.Evolution of hepatitis B virus mutation during entecavir rescue therapy in patients with antiviral resistance to lamivudine and adefovir[J].Antivir Ther. 2009, 14(7):985. [4] 中华医学会肝病学分会,中华医学会感染病学分会. 慢性乙型肝炎防治指南[J].中华肝脏病杂志,2005,13(12):881. [5] 陈 洁. 药物经济学[M]. 第3版. 成都:成都科技大学出版社,2000:97. [6] 艾伟鹏,方红成. 三种他汀类药物治疗高脂血症的经济学分析[J].现代医药卫生,2005,21(10):1200. [7] 孔晓东.药物经济学:概念、方法和应用[J].国外医学药学分册,1994,21(1):16. [8] Lok ASF,McMahon BJ. AASLD practice guidelines: Chronic hepatitis B[J]. Hepatology,2007,45(2):507. [9] Chang TT, Jia JD, Omata M,et al. New therapies for chronic hepatitis B infection[J]. Liver International,2006 26(suppl2):30. [10] Osborn MK. Safety and efficacy of telbivudine for the treatment of chronic hepatitis B[J]. Ther Clin Risk Manag,2009,5(10):789.
计量
- 文章访问数: 2679
- HTML全文浏览量: 307
- PDF下载量: 143
- 被引次数: 0