缬沙坦/氨氯地平复方制剂与ARB+CCB联用治疗高血压的药物经济学比较
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篇名: 缬沙坦/氨氯地平复方制剂与ARB+CCB联用治疗高血压的药物经济学比较
TITLE:
摘要: 目的:比较缬沙坦/氨氯地平复方制剂与血管紧张素Ⅱ受体阻滞药(ARB)+钙通道阻滞药(CCB)联用治疗高血压的有效性和经济性。方法:检索Medline、PubMed、Cochrane Library等3个英文期刊数据库,以及中国知网、维普网、万方数据等3个中文期刊数据库,检索范围设定为“题目/摘要(Title/Abstract)”,检索词为“缬沙坦/氨氯地平(Valsartan/Amlodipine)”“高血压(Hypertension)”,检索时限均为建库起至2018年5月。运用Markov模型,基于中国2017年的药品价格与医疗费用,对纳入文献中缬沙坦/氨氯地平复方制剂组与ARB+CCB组患者的有效性和经济性进行对比分析。结果:从医疗卫生系统角度分析,缬沙坦/氨氯地平复方制剂组在Markov模型中非致死性心肌梗死和非致死性卒中状态的人均治疗成本低于ARB+CCB组。与ARB+CCB组比较,缬沙坦/氨氯地平复方制剂组患者治疗的增量效用是质量调整生命年(QALY)每增加0.067 8个单位所需的增量成本为2 916.63元,其增量成本-效果比为42 988.44元/QALY。结论:与ARB+CCB联用相比,缬沙坦/氨氯地平复方制剂治疗高血压可显著降低患者非致死性心肌梗死和非致死性卒中等不良事件的发生,且可为患者节省医疗费用,更具经济性。
ABSTRACT: OBJECTIVE: To compare effectiveness and economical efficiency of valsartan/amlodipine compound preparation versus angiotensin receptor blockers (ARB)+calcium channel blockers (CCB) in the treatment of hypertension. METHODS: Retrieved from English databases as Medline, PubMed, Cochrane Library, and Chinese databases as CNKI, VIP, Wanfang database, retrieval range were “Title/Abstract”; retrieval terms were “Valsartan/Amlodipine” and “Hypertension”; retrieval time limit was from database establishment to May 2018. By Markov model, based on drug price and medical cost in 2017, the effectiveness and economical efficiency of valsartan/amlodipine compound preparation group in the included literatures were compared with that of ARB+CCB group. RESULTS: From the perspective of medical and health system, treatment cost per capita of nonfatal myocardial infarction and nonfatal stroke in Markov model of valsartan/amlodipine compound preparation group were lower than ARB+CCB group. Compared with ARB+CCB group, incremental utility of valsartan/amlodipine compound preparation group was the incremental cost was 2 916.63 yuan for quality adjusted life year (QALY) increasing each 0.067 8 units. The incremental cost-effectiveness ratio was 42 988.44 yuan/QALY. CONCLUSIONS: Compared with ARB+CCB, valsartan/amlodipine compound preparation for hypertension can significantly reduce the occurrence of adverse events such as nonfatal myocardial infarction and nonfatal stroke, and save the medical expenses for the patients. It is more economical.
期刊: 2018年第29卷第17期
作者: 李海燕,胡宇千,于智杰
AUTHORS: LI Haiyan,HU Yuqian,YU Zhijie
关键字: 缬沙坦/氨氯地平;血管紧张素Ⅱ受体阻滞药;钙通道阻滞药;高血压;经济性
KEYWORDS: Valsartan/amlodipine; Angiotensin Ⅱ receptor blocker; Calcium channel blocker; Hypertension; Economical efficiency
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