对于中间风险肺栓塞的导管血栓溶解的经济分析
Elina Pliakos1, Lauren Glassmoyer1, Taisei Kobayashi1,2
1Division of Cardiovascular Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
概括
导管血栓溶解 (CDT) 是一种中等风险的肺栓塞的经济有效的治疗方法,有可能节省大量的医疗保健费用. 这种方法提高了与单独抗凝血药物相比的生存率.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 卫生经济学 卫生经济学
背景情况:
- 肺栓塞 (PE) 带来了大量的疾病,死亡率和医疗保健支出负担.
- 导管血栓溶解 (CDT) 是一种新兴的中等风险PE治疗方法,其目标是与标准抗凝药相比获得更好的结果.
研究的目的:
- 评估导管导向血栓溶解与单独用于中等风险肺栓塞的抗凝剂的成本效益.
- 确定CDT在管理PE时的经济影响和生存益处.
主要方法:
- 开发了一个决策分析模型来比较单独使用CDT和抗凝药.
- 使用避免死亡和增量成本效益比率 (ICER) 评估了成本效益.
- 不确定性通过成本效益平面和可接受度曲线进行分析.
主要成果:
- 与单独抗凝血治疗相比,CDT显示每次避免死亡的成本节约为104,089美元.
- CDT显示,1个月的生存概率高 (0.984) 与抗凝药 (0.958) 相比.
- 在死亡率0.042的值之前,CDT仍然具有成本效益,并且在10万美元的支付意愿下有63%的机会具有成本效益.
结论:
- 预计导管血栓溶解对于中等风险的肺栓塞是具有成本效益的.
- 当CDT在临床环境中适当应用时,它可以提供相当大的成本节约.
- 该模型的发现表明,在PE管理中CDT的经济和生存情况有利.
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