单片药片和单片药片的三重抗高血压组合疗法的成本效益:基于人口的微型模拟研究
Gabriella Morabito1,2, Caterina Gregorio3,4,5, Francesca Ieva6,3,7
1Department of Statistics and Quantitative Methods, Unit of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Via Bicocca Degli Arcimboldi, 8, Milan, 20126, Italy. gabriella.morabito@unimib.it.
BMC public health
|July 6, 2024
概括
治疗高血压的三种药物单片组合 (SPC) 是具有成本效益的,可使预期寿命增加0.86年. 这一策略提供了显著的节约,主要是通过减少住院治疗,使患者和医疗保健系统受益.
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:
- 单片药组合 (SPC) 改善了高血压管理中的坚持.
- 三种药物SPC的长期成本和健康结果尚未得到充分证实.
- 这项研究评估了三种药物SPC与两种药丸治疗方案的终身成本效益.
研究的目的:
- 评估与两片药物治疗方案相比,三种药物SPC (ACE抑制剂,通道阻断剂,利尿剂) 的终身成本效益.
- 从意大利医疗保健支付人的角度分析经济影响.
- 确定SPC是否是高血压治疗的占主导地位或具有成本效益的策略.
主要方法:
- 使用多态半马尔科夫建模和微显模拟进行成本效益分析.
- 利用来自意大利伦巴第地区的40岁以上患者的医疗保健利用数据,开始SPC或两片药组合 (2015-2018).
- 预计的寿命成本和预期寿命,成本和寿命年数获得的折扣为3%;进行了概率灵敏度分析.
主要成果:
- 三种药物的SPC与两种药物的组合相比,增加了0.86年的预期寿命.
- SPC是占主导地位的策略,平均成本差异为-12欧元,主要是由于医院住院费用节省了1850欧元至2027欧元.
- 较高的药物成本SPC (3848欧元) 与两片 (3710欧元) 被其他节省所抵消;结果在人口统计学上是一致的.
结论:
- 三种药物的SPC预计在大多数支付意愿值中具有成本效益.
- 广泛采用SPC可以为患者和医疗保健系统带来显著的好处.
- 目前的低处方率突显了改善高血压管理和资源配置的错失机会.
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