摘要
目的了解临床抗帕金森病药物治疗费用的变化情况,探讨单胺氧化酶B型抑制剂(MAO-BI)与多巴胺受体激动剂(DAs)临床疗效及治疗费用差异。方法通过对2014—2019年全国30家医院的门诊帕金森病患者治疗药物处方进行统计分析,归纳及总结抗帕金森病药物的人均药品金额、人均取药量、日均治疗费用等,并对MAO-BI与DAs的常用治疗方案进行成本-效果分析。结果共纳入帕金森病患者8420例,处方分析结果显示:2014—2019年患者人均取药量及人均药品金额的降幅分别为14.0%,18.2%。司来吉兰处方金额比例及取药量比例增长率分别为268.8%,317.2%,其平均日治疗费用为3.74元。成本-效果分析结果显示:与联合DAs组相比,复方左旋多巴联合MAO-BI组加入第三大类药物平均时长延长60.57 d(P<0.05),平均日治疗费用降低16.20元(P<0.05)。结论2014—2019年间帕金森病患者抗帕金森病药物人均治疗费用不断下降,MAO-BI的处方金额占比与取药量占比不断增加,而平均日治疗费用却在不断减少。在复方左旋多巴的治疗基础上加用MAO-BI比加用多巴胺受体激动剂在延迟联用第三种抗帕金森病药物、减少平均日治疗费用方面具有明显优势。
Objective To understand changes in the treatment cost of anti-Parkinson's disease drugs in clinic and to explore differences of the clinical efficacy and cost between monoamine oxidase B inhibitors(MAO-BI)and dopamine receptor agonists(DAs)in delaying the progression of Parkinson's disease.Methods The prescriptions of medicines for Parkinson's disease in outpatients of 30 hospitals in China from 2014 to 2019 were statistically analyzed,and the per capita yearly drug payment amount,per capita yearly drug intake,and average daily treatment cost of anti-Parkinson's disease drugs were summarized.In addition,the typical treatment schemes of two medications for delaying the progression of Parkinson's disease(DAs and MAO-BI)were analyzed for cost-effectiveness.Results A total of 8420 patients with Parkinson's disease were included in this study;prescription analysis results showed that the per capita yearly drug intake and the per capita yearly drug payment amount decreased by 14.0% and 18.2% from 2014 to 2019,respectively.On the other hand,the proportion of prescription payment and the ratio of drug selegiline intake increased by 268.8% and 317.2%,respectively,and the average daily treatment cost was 3.68 CNY/day.The results of the cost-effectiveness analysis showed that compared with the control group,the average time of adding the third class of drugs into the compound levodopa combined with the MAO-BI group was prolonged by 60.57 days,and the average daily treatment cost was reduced by 16.20 CNY per day(P<0.05).Conclusion The per capita treatment cost of anti-Parkinson's disease drugs in patients decreased continuously from 2014 to 2019,and the proportion of prescription payment and drug intake of MAO-BI are increasing.Meanwhile,the average daily treatment cost is decreasing.The addition of MAO-BI to the compound levodopa has apparent advantages over the addition of dopamine receptor agonists in delaying the use of the third anti-Parkinson's disease drug and reducing the average daily treatment cost.
作者
庞文渊
朱斌
李佳
陈孝
李静
金岩
赵志刚
PANG Wenyuan;ZHU Bin;LI Jia;CHEN Xiao;LI Jing;JIN Yan;ZHAO Zhigang(Department of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Project Team of China Comprehensive Drug Evaluation Guidelines,Beijing 100026,China;Department of Pharmacy,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)
出处
《医药导报》
CAS
北大核心
2022年第10期1513-1518,共6页
Herald of Medicine
基金
北京市医院管理局临床医学发展专项(ZYLX201827)
帕金森病临床用药多中心真实世界数据综合评价项目(2-3-1-847-28)。
关键词
单胺氧化酶抑制剂
多巴胺受体激动剂
帕金森病
延缓疾病进展药物
药物经济学评价
Monoamine oxidase inhibitors
Dopamine receptor agonists
Parkinson's disease
Drugs to delay disease progression
Pharmacoeconomic evaluation
