【作者】 门鹏； 王湉； 易湛苗； 邱婷婷； 刘芳； 翟所迪；

【Author】 MEN Peng;WANG Tian;YI Zhan-miao;QIU Ting-ting;LIU Fang;ZHAI Suo-di;Department of Pharmacy,Peking University Third Hospital;School of Basic Medicine and Clinical Pharmacy,China Pharmaceutical University;

【机构】 北京大学第三医院药剂科； 中国药科大学基础医学与临床药学学院；

【摘要】 目的:研究脑蛋白水解物注射液治疗急性缺血性脑卒中的经济性。方法:本研究基于医疗系统视角。临床效果数据来源于对脑蛋白水解物注射液治疗急性缺血性脑卒中的临床随机对照试验荟萃分析的结果,结局指标选分别用死亡率和NIHSS量表测得的治疗响应率;成本考虑直接医疗成本,根据《中国急性缺血性脑卒中诊治指南2014》的诊疗项目和北京市现行价格计算。结果:纳入的3篇临床试验的给药时间均为10天,随访90天。在常规治疗急性缺血性脑卒中的基础上,联用或不联用脑蛋白水解物注射液,治疗响应率分别为50.9%和47.6%,死亡率分别为5.4%和6.1%,成本分别为3351.5元和2091.5元,增量成本-效果比按两指标分别为406.4和1800.0;敏感性分析显示,当两个效果指标分别取上限或下限值时,结果不一致。结论:基于目前可获得的研究证据,使用脑蛋白水解物注射液治疗急性缺血性脑卒中具有较好的成本-效果,但需要更大样本、更长期治疗研究进一步验证。更多还原

【Abstract】 Objective: To evaluate the pharmacoeconomic features of cerebrolysin in treating cerebral ischemic stroke(CIS). Methods: For cerebral ischemic stroke, the effectiveness outcomes were therapeutic response rate(based on NIHSS) and mortality. Direct medical costs were considered and derived from market prices in Beijing and items in "China Guidelines for Diagnosis and Treatment of Acute Ischemic Stroke(2014)". Results: Therapeutic and follow-up periods were 10 and 90 days respectively among the 3 included trials. When treating CIS by regular treatments with or without cerebrolysin, therapeutic response rate was 50.9% or 47.8%, mortality was 5.4% or 6.1%, direct medical costs was $3351.5 or $2091.5, respectively. The incremental cost-effectiveness ratio(ICER) was 406.4 or 1800.0, when using therapeutic response rate or mortality as effectiveness outcome. Sensitivity analysis showed that the ICER was, to a great extent, influenced by value of effectiveness outcomes. Conclusion: According to economic analysis based on current clinical evidence, cerebrolysin is cost-effectiveness in treating CIS. Further researches are still required to fully ascertain these results.更多还原