您好,欢迎访问三七文档
当前位置:首页 > 医学/心理学 > 药学 > 5种方案治疗拉米夫定耐药乙型肝炎的药物经济学评价-龚银华-陈蓉
ChineseJournalofNewDrugs2016,25(20)239520162520-201407、。17712661286E-mailyhgong89@gmail.com。、。051267780282E-mailrongchen_76@aliyun.com。··5215006、、、、。5、。、、、、42965556586878961081266.67%75.00%76.92%85.00%87.94%。5。3。。、85%。R978.7A1003-3734201620-2395-06Pharmacoeconomicevaluationoffivetreatmentschemesagainstlamivudine-resistanthepatitisBGONGYin-huaCHENRongTheFirstAffiliatedHospitalofSoochowUniversitySuzhou215006ChinaAbstractObjectiveToconductapharmacoeconomicevaluationoflamivudinecombinedwithadefovirdipivoxiltelbivudinecombinedwithadefovirdipivoxilentecavircombinedwithadefovirandtenofovirandpegylatedinterferoncombinedwithadefovirdipivoxilrespectivelyinthetreatmentoflamivudine-resistanthepatitisB.MethodsAretrospectivestudywasperformedbycollectingandcomparingdataoffivetreatmentschemes.Costandeffectiverateswerecalculatedforeachoptimaltherapeuticscheme.ResultsCostsandeffectiveratesofthementioned5treatmentschemeswere4296CNY/66.67%5556CNY/75.00%5868CNY/76.92%7896CNY/85.00%and10812CNY/87.94%respectively.ConclusionLamivudinecombinedwithadefovirdipivoxilhasthelowestcost-effectivenessratioamongfiveschemesandisthusthebestschemefromacost-effectiveperspective.Allthefirstthreegroupsareoralcombinationtherapiesamongwhichentecavircombinedwithadefovirdipivoxilhasthehighestclinicalefficacy.Generallyconsideringentecavircombinedwithadefovirisamoreeconomicschemethanothers.Bothtenofovirandpegylatedinterferoncombinedwithadefovirdipivoxilhaveeffectiveratesof>85%yettheir△C/△Eratioisgreaterthanothers.Keywordslamivudine-resistanthepatitisBpharmacoeconomicChineseJournalofNewDrugs2016,25(20)239620162520chronichepatitisBCHBhepatitisBvirusHBV15%~49%1。HBVCHB。/nuc1eoside/nucleo-tideanalogsNAs。HBVCHBNAs51amivudineLAM、adefovirdipivoxilADV、tel-bivudineLdT、entecavirETVtenofovirTDF。LAM2。LAMCHB1、2、34YMDD14%38%49%66%3-5。ADVNAs。ETVLdTHBV。NAsCHB、、。tenofovirdisoproxilfumarateTDF2008foodanddrugadministra-tionFDACHB。30TDFCHB6。WHO2015CHB“WHO”APASLCHB。WHONAsETVTDF。2015APASLTDFETVADVLdTLAMETVTDF。2015WHONAsTDFAPASLLAMLdTTDFADVTDFETV。TDF7-9HBV。5。5-、。120151~12CHB3~152014《》、、、、、、。256CHB5。061224。、。22.11。1lamivudine100mg×14telbivudine600mg×7entecavir0.5mg×7adefovirdipivoxil10mg×14tenofovirdi-soproxilfumarate300mg×30AspenPortElizabethPtyLtd.α-2apegylatedinterferonα-2a180μg/0.5mL/2.25①LAM+ADVLAM100mgqdpo+ADV10mgqdpo。②LdT+ADVLdT600mgqdpo+ADV10mgqdpo。③ETV+ADVETV0.5mgqdpo+ADV10mgqdpo。④TDFTDF300mgqdpo。⑤+ADV+ADV10mgqdpo。24。5061224ALTHBeAgHBV-DNA。ChineseJournalofNewDrugs2016,25(20)2397201625203《》。HBeAgHBV-DNA。50%HBeAgHBV-DNA。。。4HBeAgeeHBV。HBV-DNAHBeAg。HBeAgHBV-DNA。、ALT、HBeAgHBV-DNA。5-。、。、、。2015。2。2//10mg×14151.00323.570.5mg×7169.00724.29100mg×14207.00443.57600mg×7156.00668.57300mg×301420.001420.00CHBV-DNA、。。HBV-DNA150601503603C=360×3=1080。C、。5、、。C3。C=C+C+C。3CCCCLAM+ADV1080.004296.00—5376.00LdT+ADV1080.005556.00—6636.00ETV+ADV1080.005868.00—6948.00TDF1080.007896.00—8976.00+ADV1080.0010812.00168.0012060.006。7Excel2007。SPSS17.0post-hoctest。χ2。P<0.05。1256CHB5、、。LAM+ADV61283336.42±12.90LdT+ADV43241936.83±12.42ETV+ADV42231937.57±13.98TDF57342336.72±12.37+ADV53332037.98±13.91。22.14HBV-DNA、HBeAg、ALT4。ChineseJournalofNewDrugs2016,25(20)2398201625204%HBV-DNAHBeAgALTLAM+ADV88.8922.2280.0066.67LdT+ADV87.0029.0077.6875.00ETV+ADV86.6713.3386.6776.92TDF85.2325.0081.7785.00+ADV79.1035.0075.9187.94P0.570.150.7760.052.255-。incremen-talcost-effectivenessratioICER。HBV-DNA、HBeAgALTICER5~7。5HBV-DNAICERC/HBV-DNAE/%C/EICERaICERbLAM+ADV5376.0088.8960.48——LdT+ADV6636.0087.0076.28-66666.67-66666.67ETV+ADV6948.0086.6780.17-70810.81-94545.45TDF8976.0085.23105.32-98360.66-140833.33+ADV12060.0079.10152.47-68273.75-50309.95ICERaLAM+ADVICERb6HBeAgICERC/HBeAgE/%C/EICERaICERbLAM+ADV5376.0022.22241.94——LdT+ADV6636.0029.00228.8318584.0718584.07ETV+ADV6948.0013.33521.23-17682.79-1991.06TDF8976.0025.00359.04129496.4017377.89+ADV12060.0035.00344.5752300.4730840.007ALTICERC/ALTE/%C/EICERaICERbLAM+ADV5376.0080.0067.20——LdT+ADV6636.0077.6885.43-54310.34-54310.34ETV+ADV6948.0086.6780.1723568.223470.52TDF8976.0081.77109.77203389.83-41387.75+ADV12060.0075.91158.87-163422.98-52627.988。。。8LAM+ADVLdT+ADV、ETV+ADV、TDF+ADVICER15126.0515336.5919639.9331424.54。ICERLdT+ADVLAM+ADV15126.05ETV+ADVLdT+ADV81875TDFETV+ADV25099.01+ADVTDF104897.96。ChineseJournalofNewDrugs2016,25(20)23992016252085C/E/%C/EICERaICERbLAM+ADV5376.0066.678063.60——LdT+ADV6636.0075.008848.0015126.0515126.05ETV+ADV6948.0076.929032.7615336.5981875.00TDF8976.0085.0010560.0019639.9325099.01+ADV12060.0087.9413713.9031424.54104897.962.3ICER。20%ICER。1、ICER。15ICER3。142、、creatinephosphokinaseCK。135、、。2015APASLTDFADV3。WHO。CHBWHO。2015APASLCHBLdTETVHBV。10、CK。1HBV-DNA、。。。24。245。4HBV-DNAICER。ICER。。。。Meta、。2016TDF67.3%。HBV。。。ChineseJournalofNewDrugs2016,25(20)2400201625201.48J.2014224266-271.2.J.2012186754-756.3LOKASLAICLLEUNGNetal.Long-termsafetyoflamivu-dinetreatmentinpatientswithchronichepatitisBJ.Gastroen-terology200312561714-1722.4.2200ⅣJ.2003112103-108.5.J.2003426382-387.6.J.20144168-72.7MARCELLINPGANEEBUTIMetal.Regressionofcirrho-sisduringtreatmentwithtenofovirdisoprox
本文标题:5种方案治疗拉米夫定耐药乙型肝炎的药物经济学评价-龚银华-陈蓉
链接地址:https://www.777doc.com/doc-1354406 .html