论文部分内容阅读
目标:该项研究的目的是评估骨质疏松患者口服双磷酸盐的服药不依从性所造成的临床和经济负担,并评价依从促进干预所产生的潜在成本效益。方法:运用马尔科夫微观模型评估无治疗、实际依从治疗、三年或以上完全依从治疗等三种情境下的成本与产出(产出通过骨折数量和质量调整生命年来进行评价)。实际依从性数据来自于已发表的实验性研究结果。该研究测算了每单位QALY的成本,并在三种方案间,对该指标进行比较。结果:实际依从患者骨折预防和质量调整生命年增益仅为完全依从患者的38.2%和40.7%。与无治疗的患者相比,实际依从患者每获得一个质量调整生命年的增益成本,为10 279欧。与实际依从性患者比较,完全依从患者节约成本。推论:该研究表明,超过一半的口服双磷酸盐类骨质疏松患者的临床潜在效益由于依从性差而流失。在现有成本基础上,通过干预促进患者依从性,有利于资源的有效利用。
Objectives: The purpose of this study was to assess the clinical and financial burden of non-adherence to oral bisphosphonates in patients with osteoporosis and to evaluate the potential cost-effectiveness of adherence-facilitated interventions. Methods: Markov models were used to evaluate the costs and outcomes of three scenarios: no treatment, actual compliance, three years or more complete compliance (output was assessed by the number of fractures and the quality of life adjusted years). The actual compliance data comes from published experimental findings. The study measured the cost per unit of QALY and compared the three scenarios. Results: The actual year-to-year benefit of prevention and quality adjustment of patients’ fractures was only 38.2% and 40.7% of the total compliance patients. Compared to untreated patients, the actual cost per eligible patient for obtaining a quality-adjusted life year was 10,279. Compared with the actual compliance of patients, patients fully comply with cost savings. Corollary: This study shows that more than half of patients with oral bisphosphonates osteoporosis clinical potential benefits due to poor compliance and loss. Based on the existing cost, promoting patient compliance through intervention is conducive to the effective use of resources.