阿格列汀治疗2型糖尿病的药物经济学评价

发布时间：2018-02-10 21:22

本文关键词： 阿格列汀型糖尿病成本-效果分析法文献二次分析药物经济学　出处：《中国药房》2016年26期 　论文类型：期刊论文

【摘要】：目的:评价阿格列汀治疗2型糖尿病的经济性,为相关研究提供循证依据。方法:计算机检索Cochrane Library、Pubmed、EMBase、中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库等数据库中阿格列汀联用传统降糖药与单用传统降糖药比较治疗2型糖尿病的随机对照试验(RCT),检索时间为建库至2014年3月。基于文献二次分析思路,从文献中提取效果指标和疗程,从患者角度出发,以药物日均治疗费用计算成本,并采用成本-效果分析法,对阿格列汀联用传统降糖药方案与单用传统降糖药方案的经济性进行评价。结果与结论:共纳入符合标准的RCT文献6篇。当阿格列汀与二甲双胍联用疗程为12周时,以糖化血红蛋白(HbA_1c)降低值作为效果指标考察,成本-效果较差;当疗程增加到26周时,以HbA_1c达标率作为效果指标考察,成本-效果较差;但当阿格列汀价格降低10%或试验组效果取95%置信区间(CI)上限时,其成本-效果优于单用二甲双胍组。以HbA_1c降低值作为效果指标考察,阿格列汀联用吡格列酮治疗12周的成本-效果较好,但当疗程增加到26周时,成本-效果较差;疗程增加到26周时,以HbA_1c达标率为效果指标的敏感度分析结果显示,试验组效果指标取95%CI上限时,成本-效果优于单用吡格列酮组。阿格列汀联用伏格列波糖治疗12周时,以HbA_1c降低值作为效果指标,成本-效果优于单用伏格列波糖组。建议今后应开展基于RCT的阿格列汀药物经济学研究,以及改善糖尿病患者长期生活质量的药物经济学研究。
[Abstract]:Objective: to evaluate the economics of Aglitine in the treatment of type 2 diabetes and to provide evidence based basis for relevant studies. Methods: the Cochrane Library Pubmedmedus EmBase, China knowledge Network, Weipu.com, and Wanfang data knowledge Service platform were searched by computer. A randomized controlled trial of Aglentin combined with traditional hypoglycemic drugs and traditional hypoglycemic drugs for type 2 diabetes mellitus was conducted in the database of Chinese Biomedical Literature Database. The retrieval time was built up to March 2014. Based on the thought of second analysis of the literature, a randomized controlled trial was carried out to compare the treatment of type 2 diabetes mellitus with traditional hypoglycemic drugs. The effect index and course of treatment were extracted from the literature. From the point of view of patients, the cost was calculated with the average daily treatment cost of the drug, and the cost-effect analysis method was used. To evaluate the economy of Aglitine combined with conventional hypoglycemic regimen and single conventional hypoglycemic regimen. Results and conclusions: six RCT articles were included. When Aglentin was treated with metformin for 12 weeks, The decrease of HbA1c in HbA1cwas used as the effect index, the cost effect was poor, when the course of treatment was increased to 26 weeks, the HbA_1c reached the standard rate as the effect index, the cost effect was poor. However, when the price of Aglentin was reduced by 10% or the effect of the test group was limited by 95% confidence interval (CI), the cost-effectiveness was better than that of metformin alone. The cost effect of Aglitine combined with pioglitazone for 12 weeks was better, but the cost effect was poor when the course was increased to 26 weeks, and the sensitivity analysis with HbA_1c compliance rate as the effect index was found when the course was increased to 26 weeks. When 95 CI was taken, the cost-effectiveness of the trial group was better than that of pioglitazone group alone. After 12 weeks of treatment, the decrease of HbA_1c was used as the index of effect. Cost-effect was better than that of Voglibose alone. It was suggested that the pharmacoeconomics study of Agletine based on RCT and the improvement of long-term quality of life of diabetic patients should be carried out in the future.
【作者单位】：四川大学华西医院药剂科;四川大学华西药学院药物经济学与药物政策研究中心;
【分类号】：R977.1+5;;R956

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