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目的:开展对噻托溴铵与异丙托溴铵在临床治疗慢性阻塞性肺疾病(COPD)患者的药物经济学研究,为临床用药决策提供依据。方法:采用回顾性研究筛选某院COPD患者,建立马尔可夫(Markov)模型对接受噻托溴铵与异丙托溴铵的患者进行模拟,并参考相关随机对照试验研究成果以及中外公开发表的文献。结果:5年噻托溴铵组和异丙托溴铵组的效果值质量调整生命年(QALYs)分别为3.90和3.87,噻托溴胺组成本为5 792.55元,比对照组减少1 262.9元,增量成本-效果比为119 977.67元/QALY。结论:在治疗COPD过程中,5年内噻托溴铵组和异丙托溴铵组治疗方案疗效相当,但噻托溴铵组的成本更低,治疗更具有成本-效果性。
OBJECTIVE: To study the pharmacology of tiotropium bromide and ipratropium bromide in the clinical treatment of patients with chronic obstructive pulmonary disease (COPD), and to provide the basis for clinical medication decision-making. Methods: A retrospective study was conducted to screen patients with COPD in a hospital. Markov model was established to simulate the patients receiving tiotropium and ipratropium bromide, and the results of related randomized controlled trials as well as Chinese and foreign published literature. Results: The QALYs for tiotropium group and ipratropium bromide group for 5 years were 3.90 and 3.87, respectively, and for tiotropium group was 5 792.55 yuan, a decrease of 1 262.9 yuan over the control group , The incremental cost-effectiveness ratio of 119 977.67 yuan / QALY. CONCLUSIONS: The treatment regimen for tiotropium and ipratropium bromide had comparable efficacy over five years in the treatment of COPD, but the cost of tiotropium was lower and the treatment more cost-effective.