基于药物的二次预防缺血性中风的趋势和成本结构
Konstantin Kohlhase1, Ferdinand O Bohmann2, Christian Grefkes2
1Goethe University Frankfurt, University Hospital, Department of Neurology, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany. kohlhase@med.uni-frankfurt.de.
Neurological research and practice
|January 1, 2025
概括
直接口服抗凝剂 (DOAC) 是二次中风预防的主要成本驱动因素,特别是在心血管血栓性中风中. 虽然双抗血小板疗法 (DAPT) 和阿司匹林的成本较低,但DOAC支出在十年内保持稳定.
科学领域:
- 药物经济学 药物经济学
- 神经学 神经学
- 心血管医学 心血管医学
背景情况:
- 二次性中风预防已经随着新的疗法,如直接口服抗凝剂 (DOAC) 和双抗血小板疗法 (DAPT) 的发展而发展.
- 这些进步在过去十年中影响了医疗保健成本.
- 了解这些治疗的经济影响对于有效的心血管风险管理至关重要.
研究的目的:
- 评估因缺血性中风后与基于药物的二次预防相关的年度治疗费用.
- 分析从2004年到2021年的药物成本趋势.
- 确定中风预防药物治疗中的主要成本驱动因素.
主要方法:
- 分析了2020年缺血性中风患者每日定义剂量 (DDD) 释放药物的净成本.
- 包括药物:乙酸,ADP抑制剂,DOAC,维生素K抗体,降脂药 (LLD),抗高血压药 (AHT) 和口服抗糖尿病药 (OD).
- 间断时间序列分析评估了2004-2021年的DDD趋势;克鲁斯卡尔-瓦利斯测试比较了跨组差异.
主要成果:
- 直接口服抗凝剂 (DOACs) 占年度药品总支出的51.6% (241,808欧元).
- 心血管栓塞性中风每名患者的年度成本最高,主要是由DOACs和抗高血压药驱动的.
- 在研究期间观察到克洛皮多格勒,普拉苏格勒,阿司匹林 (ASA) 和DOACs的DDD显著趋势变化.
结论:
- DOACs是二次中风预防的主要成本驱动因素,特别是在心血管血栓性中风.
- 双重抗血小板疗法 (DAPT) 和阿司匹林占药物总成本的很小一部分.
- 尽管药物使用趋势发生了重大变化,但在过去十年中,DOACs的成本保持相对稳定.
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