摘要
目的:探讨4种不同保肝降酶治疗方案用于治疗丙氨酸氨基转移酶(ALT)升高的慢性乙型肝炎(CHB)患者的成本与效果。方法:通过建立一个基于Markov模型的决策树模型来模拟患者疾病进程,评价以下方案的成本与效果:无治疗;异甘草酸镁每日100 mg;还原型谷胱甘肽每日1 500 mg;多烯磷脂酰胆碱每日465 mg;异甘草酸镁每日200 mg。临床数据、成本与效用数据等主要来自于已发表文献。结果:在ALT升高的CHB患者中,异甘草酸镁200 mg方案可以获得4.504个质量调整生命年(QALYs),而累积肝癌和死亡率分别为0.41%和1.99%。同其他治疗方案相比,异甘草酸镁200 mg方案的健康获益最大。同无治疗方案相比,异甘草酸镁100 mg方案在所有方案中最具成本效益比优势;同对照组相比,它可以在获得1个额外的QALYs时节省49 320元。结论:ALT升高的CHB患者使用保肝降酶方案可以节约远期的卫生成本,其中异甘草酸镁100 mg是最具优势的治疗方案。
OBJECTIVE： To investigate the cost and effectiveness of 4 protecting liver and lowering transaminase regimens for chronic hepatitis B （CHB） with elevated ALT. METHODS： A decision tree model based on Markov model was developed to simulate the disease process in patients. The costs and effects of the following regimens were evaluated： no treatment; isoglycyrrhizinatemagnesium 100 mg per day; restoreglutathione 1 500 mg per day; polyenephosphatidylcholine 465 mg per day; isoglycyrrhizinatemagnesium 200 mg per day. Clinical data, cost and effectiveness data were mainly from the published literaRtre. RESULTS： For CHB patients with elevated ALT, magnesium isoglycyrrhizinate 200 mg program could obtained 4.504 QALYs, while the cumulative liver cancer and mortality were 0.41% and 1.99%. Compared with other treatment regimens, magnesium isoglycyrrhizinate 200 mg regimen obtained the greatest health benefit. Compared with other regimens, magnesium isoglycyrrhizinate 100 mg regimen obtained the greatest cost-effectiveness ratio; compared with control group, it could save 49 320 yuan when got an additional QA- LYs. CONCLUSIONS ： Protecting liver and lowering transaminase regimens can save the cost of long-term health in CHB patients with elevated ALT, among which magnesium isoglycyrrhizinate 100 mg is the most advantageous treatment.
出处
《中国药房》
CAS
CSCD
2013年第46期4321-4324,共4页
China Pharmacy
