通过药物降低高血胆固醇水平. 药理学管理的成本效益
K A Schulman1, B Kinosian, T A Jacobson
1Department of Medicine, Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia.
JAMA
|December 19, 1990
概括
尼亚和洛瓦斯塔丁是控制高胆固醇的最具成本效益的药物,可显著降低低密度脂蛋白胆固醇和心血管风险.
科学领域:
- 心血管医学 心血管医学
- 卫生经济学 卫生经济学
- 药理学 药理学是指药理学的学科.
背景情况:
- 高血胆固醇水平是心血管疾病的重要危险因素.
- 药理干预通常用于管理失脂症.
- 评估不同降脂剂的成本效益对于临床决策至关重要.
研究的目的:
- 对高血胆固醇的各种药物治疗方法进行成本效益分析.
- 为了比较不同药物的效率,改变低密度脂蛋白胆固醇 (LDL-C) 和高密度脂蛋白胆固醇 (HDL-C) 的水平.
- 确定降低整体心血管风险的最具成本效益的疗法.
主要方法:
- 模拟了胆固醇胺,科莱斯蒂波尔,格姆菲布罗西尔,洛瓦斯塔丁,尼亚和普罗布科尔的成本效益.
- 从现有已发表的研究中估计的药理疗效.
- 计算的成本反映了每个疗法的社会资源消耗.
主要成果:
- 尼亚在降低LDL-C方面表现出最高的效率 (在5年内减少了139%的LDL-C).
- 洛瓦斯塔丁 (每天20毫克) 效率也很高 (减少177美元),而胆固醇胺效率最低 (减少347美元).
- 对于增加HDL-C,尼亚是最有效的 (116美元每%的增加),其次是gemfibrozil (271美元每%的增加).
结论:
- 尼亚和洛瓦斯塔丁 (每天20毫克) 成为控制胆固醇的最具成本效益的药物.
- 这些药物在改善脂质谱和降低心血管风险方面表现出最大的效率.
- 这些发现支持在胆固醇管理策略中使用尼亚和低剂量洛瓦斯塔丁.
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