曲克芦丁脑蛋白水解物治疗颅脑损伤的循证药物经济学评价
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摘要
目的:从医保支付方角度,评估曲克芦丁脑蛋白水解物注射液治疗颅脑损伤的经济性。方法:基于现有文献,对曲克芦丁脑蛋白水解物注射液和依达拉奉注射液治疗颅脑损伤的预后良好率进行间接比较。在此基础上,比较曲克芦丁脑蛋白水解物注射液和依达拉奉注射液治疗颅脑损伤的药品成本。结果:曲克芦丁脑蛋白水解物注射液联合常规治疗vs常规治疗治疗颅脑损伤的预后良好率分别为82. 30%(175/213)、58. 10%(63/108),有统计学差异(P <0. 05);依达拉奉注射液联合常规治疗vs常规治疗治疗颅脑损伤预后良好率分别为72. 05%(531/737)和49. 22%(348/707),有统计学差异[OR=2. 78,95%CI(2. 22,3. 48),P <0. 01];曲克芦丁脑蛋白水解物注射液联合常规治疗vs依达拉奉注射液联合常规治疗治疗颅脑损伤的预后良好率无统计学差异[OR=1. 15,95%CI(0. 56,2. 41)]。最小成本分析结果:曲克芦丁脑蛋白水解物(2,5和10 mL)和依达拉奉注射液(10 mg∶5 mL)每疗程用药费用分别为3 311. 7,2 752. 96,2 361. 38和3 557. 4元,药品费用差分别为-245. 7,-804. 44和-1 196. 02元。结论:假设其他费用如检查费用、常规治疗费用、住院费用以及不良反应处理费用等相同,颅脑损伤患者使用曲克芦丁脑蛋白水解物注射液和依达拉奉注射液的预后良好率无统计学差异。在此基础上,颅脑损伤患者使用曲克芦丁脑蛋白水解物注射液比使用依达拉奉注射液药品治疗费用低。
Objective: To evaluate the cost-effectiveness of injection of Troxerutin and Cerebroprotin Hydrolysate Injection in the treatment of craniocerebral injury from the perspective of medical insurance. Methods:The rates of favorable prognosis of patients with craniocerebral injury who received injection of Troxerutin and Cerebroprotin Hydrolysate Injection or edaravone injection of were compared based on the existing literature. Then the medical costs of the two regimens were calculated and compared. Results: The difference in the rate of favorable prognosis between Qu Ke group and regular treatment were statistically significant (82. 30% (175/213) vs 58. 10% (63/108),P≤0. 05),and so was the edaravone group [72. 05% (531/737) vs 49. 22% (348/707),OR =2. 78,95% CI (2. 22,3. 48),P < 0. 01],while the rates of favorable prognosis of QuKe group and edaravone group were not statistically different (OR = 1. 15,95% CI (0. 56,2. 41). The minimum cost analysis showed that the drug costs per treatment of Troxerutin and Cerebroprotin Hydrolysate Injection (2,5 and 10 mL) and edaravone injection (10 mg∶ 5 mL) were 3 311. 7,2 752. 96,2 361. 38 and 3 557. 4 yuan,and the differences were-245. 7,-804. 44 and-1 196. 02 yuan,respectively. Conclusion: Assuming that the other expenses such as the cost of inspection,regular treatment expenses,hospitalization expenses and the treatment cost of adverse reactions are the same for different therapeutic regimens,the medication cost of hydrolysate of lubutin will be lower than edaravone for the treatment of craniocerebral injury,based on the evidence that the rates of favorable prognosis of the two drugs had no statistical difference.
Objective: To evaluate the cost-effectiveness of injection of Troxerutin and Cerebroprotin Hydrolysate Injection in the treatment of craniocerebral injury from the perspective of medical insurance. Methods:The rates of favorable prognosis of patients with craniocerebral injury who received injection of Troxerutin and Cerebroprotin Hydrolysate Injection or edaravone injection of were compared based on the existing literature. Then the medical costs of the two regimens were calculated and compared. Results: The difference in the rate of favorable prognosis between Qu Ke group and regular treatment were statistically significant (82. 30% (175/213) vs 58. 10% (63/108),P≤0. 05),and so was the edaravone group [72. 05% (531/737) vs 49. 22% (348/707),OR =2. 78,95% CI (2. 22,3. 48),P < 0. 01],while the rates of favorable prognosis of QuKe group and edaravone group were not statistically different (OR = 1. 15,95% CI (0. 56,2. 41). The minimum cost analysis showed that the drug costs per treatment of Troxerutin and Cerebroprotin Hydrolysate Injection (2,5 and 10 mL) and edaravone injection (10 mg∶ 5 mL) were 3 311. 7,2 752. 96,2 361. 38 and 3 557. 4 yuan,and the differences were-245. 7,-804. 44 and-1 196. 02 yuan,respectively. Conclusion: Assuming that the other expenses such as the cost of inspection,regular treatment expenses,hospitalization expenses and the treatment cost of adverse reactions are the same for different therapeutic regimens,the medication cost of hydrolysate of lubutin will be lower than edaravone for the treatment of craniocerebral injury,based on the evidence that the rates of favorable prognosis of the two drugs had no statistical difference.
引文
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[16]张斌,钱春生.依达拉奉对重型颅脑损伤患者血浆8-isoPGF2α水平的影响及其临床疗效观察[J].中国临床神经外科杂志,2015,20(3):153-154.
[17]王涛,贺中正,朱莽,等.依达拉奉对重型颅脑损伤患者急性期脑水肿及神经功能的影响[J].陕西医学杂志,2017,46(1):34-36.
[18]刘西,李建明,林新国.依达拉奉治疗急性重型颅脑损伤的疗效观察[J].白求恩医学杂志,2011,9(1):9-11.
[19]陈献东,何学雄,孙军.依达拉奉对中度颅脑损伤的疗效评价[J].浙江创伤外科,2006,11(2):98-99.
[20]庄汉森.依达拉奉治疗急性重型颅脑损伤的临床观察[J].临床合理用药杂志,2009,2(15):7-8.
[21]张辉,耿煜,刘利群.依达拉奉治疗急性重型颅脑损伤的临床疗效观察[J].中西医结合心脑血管病杂志,2010,8(9):1065-1066.
[22]刘伟强.注射用曲克芦丁脑蛋白水解物制备工艺研究[J].亚太传统医药,2011,7(11):18-19.
[23]唐榕,桑纳,向帆,等.曲克芦丁脑蛋白水解物治疗急性脑梗死的系统评价[J].世界临床药物,2017,38(1):28-35.
[2]袁强,姚海军,刘华,等.华东地区颅脑创伤患者住院费用及相关因素分析[J].中华神经外科疾病研究杂志,2011,10(5):413-419.
[3]HIGGINS JPE,GREEN S.Cochrane handbook for systematic reviews of interventions version 5.1.0[EB/OL].2011.http://www.Cochrane-handbook.Org.
[4]王作伟,常会民,黄腾,等.曲克芦丁脑蛋白水解物治疗颅脑创伤的多中心随机对照临床研究[J].中华神经外科杂志,2017,33(7):669-672.
[5]樊应平.依达拉奉治疗急性重度颅脑损伤的临床观察[J].临床合理用药杂志,2014,7(50):38-39.
[6]耿飞,陈迎春.依达拉奉在急性重型颅脑损伤治疗中的应用效果[J].实用医药杂志,2011,28(2):123-124.
[7]李凯,周杰,车万民,等.依达拉奉对中、重型颅脑损伤患者脑水肿及预后的影响[J].实用临床医药杂志,2014,18(16):128-130.
[8]梁大胜,庞晓军,杜正隆.依达拉奉治疗急性颅脑损伤的临床研究[J].现代预防医学,2012,39(7):1814-1815.
[9]林锦波,兰周华,张云凤,等.依达拉奉治疗急性重型颅脑损伤的疗效观察[J].中国实用神经疾病杂志,2008,11(11):11-14.
[10]彭涛,李定君,徐宏,等.早期使用依达拉奉注射液预防中重型颅脑损伤患者并发外伤性脑梗死[J].四川医学,2015,36(11):1512-1514.
[11]石林,石亚昕,贾建丽,等.依达拉奉治疗急性重型颅脑损伤34例[J].中国药业,2010,19(19):71-72.
[12]王红涛,任菊花,赫延峰.依达拉奉治疗急性重型颅脑损伤的疗效观察[J].临床医学,2011,31(3):10-11.
[13]温剑峰,钱锁开,杨绮帆,等.依达拉奉对急性重型颅脑损伤疗效的临床观察[J].中华神经医学杂志,2006,5(9):953-954.
[14]肖柯.依达拉奉治疗66例脑外伤患者临床观察[J].齐齐哈尔医学院学报,2013,34(12):1791-1792.
[15]詹师,潘在轩,吴新建.依达拉奉对重型颅脑损伤患者血清NSE、S-100β的影响及疗效观察[J].海南医学院学报,2010,16(5):552-554.
[16]张斌,钱春生.依达拉奉对重型颅脑损伤患者血浆8-isoPGF2α水平的影响及其临床疗效观察[J].中国临床神经外科杂志,2015,20(3):153-154.
[17]王涛,贺中正,朱莽,等.依达拉奉对重型颅脑损伤患者急性期脑水肿及神经功能的影响[J].陕西医学杂志,2017,46(1):34-36.
[18]刘西,李建明,林新国.依达拉奉治疗急性重型颅脑损伤的疗效观察[J].白求恩医学杂志,2011,9(1):9-11.
[19]陈献东,何学雄,孙军.依达拉奉对中度颅脑损伤的疗效评价[J].浙江创伤外科,2006,11(2):98-99.
[20]庄汉森.依达拉奉治疗急性重型颅脑损伤的临床观察[J].临床合理用药杂志,2009,2(15):7-8.
[21]张辉,耿煜,刘利群.依达拉奉治疗急性重型颅脑损伤的临床疗效观察[J].中西医结合心脑血管病杂志,2010,8(9):1065-1066.
[22]刘伟强.注射用曲克芦丁脑蛋白水解物制备工艺研究[J].亚太传统医药,2011,7(11):18-19.
[23]唐榕,桑纳,向帆,等.曲克芦丁脑蛋白水解物治疗急性脑梗死的系统评价[J].世界临床药物,2017,38(1):28-35.