本文選題：阿侖膦酸鈉 + 骨質(zhì)疏松��； 參考：《中國(guó)藥房》2017年17期

【摘要】：目的:評(píng)價(jià)阿侖膦酸鈉預(yù)防絕經(jīng)后婦女骨質(zhì)疏松性骨折的經(jīng)濟(jì)性,為骨質(zhì)疏松及骨量低下患者選擇經(jīng)濟(jì)、有效的藥物治療方案提供參考。方法:選擇Markov經(jīng)濟(jì)學(xué)模型,以基礎(chǔ)用藥(鈣劑與維生素D3)和基礎(chǔ)用藥聯(lián)合阿侖膦酸鈉的隨機(jī)對(duì)照試驗(yàn)文獻(xiàn)數(shù)據(jù)作為基線數(shù)據(jù),使用Tree Age Pro 2011軟件進(jìn)行成本-效用分析。以質(zhì)量調(diào)整生命年(QALY)及增量成本效用比(ICUR)作為經(jīng)濟(jì)學(xué)評(píng)價(jià)指標(biāo),通過單因素敏感度分析考察所建模型的穩(wěn)定性。結(jié)果:基礎(chǔ)用藥組的QALY為0.704年,聯(lián)合用藥組的QALY為0.708年,兩組間的ICUR為714 252.44。對(duì)于髖部骨折后期和發(fā)生其他骨折的人群,聯(lián)合用藥組均是高成本、低收益,明顯不具有經(jīng)濟(jì)學(xué)優(yōu)勢(shì);但是對(duì)于發(fā)生椎體骨折的人群,聯(lián)合用藥組發(fā)生骨折的累計(jì)概率明顯低于基礎(chǔ)用藥組,兩組間的ICUR僅為13 902.17,顯示出經(jīng)濟(jì)學(xué)優(yōu)勢(shì);對(duì)于發(fā)生髖部骨折的人群,基礎(chǔ)用藥組和聯(lián)合用藥組發(fā)生骨折的累計(jì)概率相同,兩組間的ICUR為19 109.00,顯示出經(jīng)濟(jì)學(xué)優(yōu)勢(shì);對(duì)于發(fā)生腕部骨折的人群而言,療效與經(jīng)濟(jì)性有待進(jìn)一步探討。結(jié)論:對(duì)于骨質(zhì)疏松性骨折的低風(fēng)險(xiǎn)人群使用鈣劑和維生素D3來(lái)預(yù)防骨折更為經(jīng)濟(jì);而對(duì)于易發(fā)生椎體和髖部骨折的高風(fēng)險(xiǎn)人群,選擇阿侖膦酸鈉聯(lián)合基礎(chǔ)用藥則兼顧了有效性與經(jīng)濟(jì)性。
[Abstract]:Objective: to evaluate the economic efficiency of alendronate in preventing postmenopausal women with osteoporotic fracture, and to provide a reference for the choice of economic and effective drug therapy for patients with osteoporosis and low bone mass. Methods: a Markov economic model was used to analyze the cost and utility of basic drugs (calcium and vitamin D3) and alendronate combined with alendronate. The baseline data were analyzed with Tree Age Pro 2011 software. The QALY and ICUR were used as economic evaluation indexes, and the stability of the model was investigated by single factor sensitivity analysis. Results: QALY was 0.704 years in the basic medication group, 0.708 years in the combined medication group, and ICUR was 714 252.44 in the two groups. For the later period of hip fracture and the population with other fractures, the combination treatment group was high cost, low income, obviously no economic advantage, but for the people with vertebral fracture, The cumulative probability of fracture in the combined treatment group was significantly lower than that in the base drug group, and the ICUR between the two groups was only 13 902.17, which showed the advantage of economics. The ICUR of the two groups was 19.109.00, which showed the advantage of economics. Conclusion: it is more economical to use calcium and vitamin D3 to prevent the fracture in the low risk population of osteoporosis fracture, but it is more economical to use calcium and vitamin D 3 in the high risk group of vertebral body and hip fracture. The choice of alendronate combined with basic medication is both effective and economical.
【作者單位】： 天津市天津醫(yī)院藥學(xué)部;天津醫(yī)科大學(xué)臨床醫(yī)學(xué)院;
【分類號(hào)】：R580;R683

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