对患有心力衰竭的黑人,固剂量组合的异索二酸盐和拉治疗的成本效益
Derek C Angus1, Walter T Linde-Zwirble, S William Tam
1Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA. angusdc@upmc.edu
Circulation
|December 14, 2005
概括
在A-HeFT试验中,固定剂量异体二酸盐/化 (ISDN/HYD) 减少了心力衰竭住院和医疗费用. 这种疗法在治疗非裔美国人的心力衰竭方面表现出有利的成本效益.
科学领域:
- 心血管医学 心血管医学
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
背景情况:
- 非洲裔美国人心力衰竭试验 (A-HeFT) 证明,固定剂量异化二酸盐/化 (ISDN/HYD) 改善了临床结果.
- 在这个特定人群中,ISDN/HYD治疗的资源利用率和成本效益需要评估.
研究的目的:
- 评估ISDN/HYD治疗在A-HeFT试验群体中的资源使用,医疗成本和成本效益.
- 为了确定ISDN/HYD疗法是否与其临床益处一起提供了有利的经济概况.
主要方法:
- 来自A-HeFT试验的资源使用数据使用美国联邦成本来源进行了分析.
- 试验内部的成本和成本效益是在延长的时间范围内建模的,包括美国社会终身参考案例.
- 在ISDN/HYD和安慰剂组中,与心力衰竭相关的和总的医疗保健成本进行了比较,不包括间接成本.
主要成果:
- 在ISDN/HYD组中,与心力衰竭相关的住院病例显著减少 (0.33对0.47每人,P=0.002),住院时间更短 (6.7对7.9天,P=0.006).
- 除了研究药物费用外,ISDN/HYD治疗与较低的平均每人心力衰竭相关费用 (5,997美元与9,144美元相比,P=0.04) 和总医疗费用 (15,384美元与19,728美元相比,P=0.03) 相联系.
- 在试验期间,ISDN/HYD疗法被发现占主导地位 (降低成本和改善结果),预计的成本效益从2年的16600美元/生命年到一生中的41800美元/生命年.
结论:
- ISDN/HYD治疗不仅改善了临床结果,而且在A-HeFT人群中显著降低了资源使用和医疗费用.
- 降低成本的主要驱动因素是住院病例的大幅减少.
- 预计ISDN/HYD治疗的长期使用对这一患者群体具有有利的成本效益.
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