门诊治疗慢性阻塞性肺疾病(COPD)加重期抗生素方案的成本-效果分析

Acevski Stevche, M. Jordan, Sterjev Zoran, Zareski Rubin, Kapedanovska Nestorovska Aleks, ra, S. Ljubica
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引用次数: 1

摘要

即使在发达国家,卫生保健资源的分配和寻找如何在卫生保健系统内优先考虑支出的方法也是一个热点问题。引进新的医疗产品和技术是卫生保健费用增加的一个重要驱动因素。慢性阻塞性肺病是全球五大发病和死亡原因之一。本研究的目的是评估抗菌药物治疗慢性阻塞性肺病急性加重的成本效益。成本效益分析是根据马其顿职业健康研究所发表的两项观察性"现实世界"研究的数据进行的。方法是基于尽可能多的步骤计算ICER,直到满足所有排除标准。所有ICER都使用成本效益平面进行解释。阿莫西林与克拉维酸和头孢呋辛在其他抗生素治疗方案中占主导地位。强力霉素、头孢呋辛、头孢多肟和莫西沙星是具有成本效益的替代品。在决定时,可用预算的大小和患者的支付意愿将是关键因素。这项研究的结果提供了数据和有用的信息,哪种抗生素将以最低的生产成本获得最佳的预期结果。
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Cost Effectiveness Analysis of Antibiotic Regimens Used in Outpatient Treatment of Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)
Allocation of the resources in health care and finding a way how to prioritize spending within health care systems are hot issue, even in the developed countries. Introduction of new medical products and technologies is one important driver for increased health care costs. COPD is among top five causes of morbidity and mortality worldwide. The aim of this study is to evaluate cost effectiveness of antimicrobial regiments for treatment of acute exacerbation of COPD. Cost effectiveness analysis was performed based on data from two published observational, “real world” studies carried in Institute for occupational Health of Macedonia. Methodology is based on calculation of ICER in as many steps as needed until all exclusion criteria`s are met. All ICER`s are interpreted using cost effectiveness plane. Amoxicillin with clavulanic acid and cefuroxime dominated over other antibiotic regiments. Doxycycline, cefuroxime, cefpodoxime and moxifloxacin are cost-effective alternatives. When deciding, size of the available budget and patient’s willingness to pay will be key factors. The results of this study provide data and useful information which antibiotic will give best expected outcomes, with least produced costs.
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