与安慰剂相比,eplerenone的成本效益在患有心肌梗塞的患者中,由左心室功能障碍和心力衰竭复杂化
William S Weintraub1, Zefeng Zhang, Elizabeth M Mahoney
1Emory University, 1256 Briarcliff Rd, Suite 1N, Atlanta, GA 30306, USA. wweintr@emory.edu
Circulation
|February 23, 2005
概括
在心肌梗塞后心力衰竭的患者中,eplerenone显著降低了死亡率. 这种阿尔多素阻断剂是一种经济有效的治疗方法,增加了为改善患者结果而获得的寿命.
科学领域:
- 心脏病学 心脏病学
- 药物经济学 药物经济学
- 临床试验 临床试验
背景情况:
- 在心肌梗塞后心力衰竭患者的EPHESUS试验中,用eplerenone阻断阿尔多斯特表明死亡率降低.
- 在EPHESUS研究中确定了eplerenone在改善这一患者群的存活率方面的有效性.
研究的目的:
- 评估与安慰剂相比,eplerenone在患有左心室缩功能障碍和急性心肌梗塞后心力衰竭的患者中的成本效益.
- 评估eplerenone在改善生存和生活质量的经济价值.
主要方法:
- 一个随机试验6632名患者比较eplerenone和安慰剂,平均随访时间为16个月.
- 共同初级终点包括全因死亡率和心血管死亡率/住院治疗的组合.
- 分析了资源利用 (住院治疗,门诊服务,药物),eplerenone的价格为3.60美元/天.
主要成果:
- 根据使用的生存数据来源 (弗拉明汉姆,萨斯喀彻温,沃斯特) 根据使用的生存数据来源,使用eplerenone会增加0.06至0.13年的寿命.
- 增量成本效益比率从每年获得的生命年数为10,402美元至21,876美元.
- 与安慰剂相比,在试验期间,eplerenone的成本高出1391美元.
结论:
- 在急性心肌梗塞后心力衰竭的患者中,eplerenone有效降低死亡率.
- 根据增加寿命的标准标准,这种治疗被认为是成本有效的.
- 在这种高风险人群中,eplerenone提供了一种有价值的治疗选择,可以改善长期的结果.
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