萨库比特里尔/瓦尔萨坦的剂量模式和剂量效应:基于索赔的回顾性队列研究
Jillian M Rung1, Tyson S Barrett1, Keith LeJeune1,2
1Enterprise Analytics, Highmark Health, Pittsburgh, Pennsylvania, United States of America.
大多数患者从最低剂量开始服用萨库比特里尔/瓦尔沙坦 (SAC/VAL),并不会增加剂量. 较高的SAC/VAL剂量与较少的住院和较低的医疗费用有关,这表明显著的临床和经济效益.
科学领域:
- 心脏病学 心脏病学
- 药物经济学 药物经济学
- 现实世界的证据.
背景情况:
- 萨库比特里尔/瓦尔沙坦 (SAC/VAL) 是用于心力衰竭管理的关键药物.
- 指南建议对SAC/VAL进行定位,以达到最佳疗效的目标剂量.
- 现实世界的坚持和定位模式并没有得到很好的描述.
研究的目的:
- 分析萨库比特里尔/瓦尔沙坦 (SAC/VAL) 的实际剂量和定位模式.
- 调查SAC/VAL剂量与医疗保健利用和成本之间的关联.
主要方法:
- 对发起SAC/VAL (2020-2022) 的成人健康计划成员进行回顾性队列分析.
- 招生标准:年龄在18-100岁之间,连续入学,以及良好的坚持 (N=2,977).
- 索赔数据用于评估剂量模式,成本和住院费用.
主要成果:
- 大多数成员 (76%) 开始使用最低剂量的SAC/VAL;只有31%的成员升高了剂量.
- 只有19%的人在最后一次充血时达到目标剂量.
- 较高的终端SAC/VAL剂量与明显较少的入院和较低的护理总成本相关.
结论:
- 大多数患者仍然服用最低的SAC/VAL剂量,不遵守定位指南.
- 更高的SAC/VAL剂量显示出显著的临床和成本效益.
- 需要进一步的研究来确定剂量定位的障碍,并优化患者的治疗结果.
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