4种方案治疗2型糖尿病的成本-效果分析

目的:比较4种方案治疗2型糖尿病的成本-效果。方法:将2009-2010年入选的2型糖尿病患者随机分为A组(72例,阿卡波糖)、B组(72例,格列美脲)、C组(71例,二甲双胍)、D组(71例,瑞格列奈+二甲双胍)并进行治疗。评价其疗效并进行成本-效果分析。结果:治疗后,4组空腹血糖及餐后2h血糖的总有效率两两比较差异均无统计学意义(P>0.05);4组成本分别为798.32、258.54、184.55、210.32元;对空腹血糖的成本-效果比分别为942.53、310.37、225.89、240.92;对餐后2h血糖的成本-效果比分别为845.68、300.28、214.84、237.11;A、B、D组相对于C组对空腹血糖的增量成本-效果比分别为20459、4624.38、460.18,对餐后2h血糖的增量成本-效果比分别为7220.82、36995.00、920.36。结论:二甲双胍治疗2型糖尿病成本较低,但瑞格列奈联合二甲双胍控制2型糖尿病患者空腹血糖和餐后2h血糖的成本-效果比较优。

Cost-effectiveness Analysis of 4 Therapeutic Schemes in the Treatment of Type 2 Diabetes Mellitus

To compare the cost-effectiveness of four treatment schemes on type 2 diabetes mellitus. METHODS： Included type 2 diabetes mellitus patients during 2009--2010 were randomly divided into group A （72 cases, acarbose）, group B （72 cases, glimepride）, group C （71 case, metformin）, group D （71 cases, repaglinide＋metformin）. Therapeutic efficacies of those groups were evaluated and cost-effect analysis was conducted. RESULTS： There was no statistical significance in the total ef- fective rate of fasting blood glucose and 2 h blood glucose after meal among 4 groups after treatment （P〉0.05）. The costs of 4 groups were 798.32 yuan, 258.54 yuan, 184.55 yuan and 210.32 yuan, respectively. The cost-effectiveness ratios of fasting blood sugar were 942.53, 310.37, 225.89 and 240.92. The cost-effectiveness ratio of blood sugar 2 h after meal were 845.68, 300.28, 214.84 and 237.11; The incremental cost-effectiveness ratios of fasting blood glucose in group A, B, D were 20 459, 4 624.38, 460.18, compared with group C; The incremental cost-effectiveness ratios of blood glucose 2 h after meal were 7 220.82, 36 995.00, 920.36. CONCLUSION： The cost of metforrnin in the treatment of type 2 diabetes mellitus is low, but it is best to use reDajzlinide combined with metformin to control cost-effectiveness ratio of fastin~ blood ~lucose and blood ~lHe~o~ 9, h after rne~nl