阿卡波糖与二甲双胍治疗2型糖尿病的成本-疗效分析

目的 比较阿卡波糖与二甲双胍治疗2型糖尿病的成本-疗效,选择符合药物经济学的药物.方法 147例门诊2型糖尿病患者按治疗方法分为阿卡波糖组（n=69）与二甲双胍组（n=78）,分别接受阿卡波糖片（50mg/次,3次/d）和二甲双胍片（0.5g/次,3次/d）口服治疗12周.药物经济学评价以成本（C）/疗效（E）比值表示.结果 2组治疗后的空腹血糖（FPG）和餐后2h血糖（2hPG）均明显下降,与治疗前比较差异均有统计学意义（P＜0.05）,但治疗前及治疗后2组间FPG和2hPG比较差异无统计学意义（P＞0.05）.以FPG作为评价指标,二甲双胍组和阿卡波糖组总有效率分别为87.18％和84.06％,差异无统计学意义（P＞0.05）,C/E比值分别为5.06元和7.59元.以2hPG作为评价指标,二甲双胍组和阿卡波糖组总有效率分别为88.46％和82.61％,差异无统计学意义（P＞0.05）,C/E比值分别为4.99元和7.73元.结论 二甲双胍治疗2型糖尿病比阿卡波糖更经济,符合药物经济学原则.

Cost-effectiveness analysis of acarbose and metformin for the treatment of type 2 diabetes mellitus

Objective To compare the cost effectiveness of acarbose and metformin for the treatment of type 2 dia betes mellitus, so as to determine which one is more cost effective and in accordance with the principles of pharmaco economics. Method 147 type 2 diabetes mellitus patients were devided into acarbose group （ n = 69 ） and metformin group （n = 78 ）. Acarbose group received acarbose treatment （50 mg given orally 3 times a day） and metformin group re ceived metformin treatment （0.5 g given 3 times a day）. All the patients in the two groups were treated for 12 weeks and then pharmacoeconomic evaluation was performed and expressed as cost （C） /effectiveness （E） ratio. Results The lev els of fasting plasma glucose （FPG） and 2 hour plasma glucose （2hPG） were significantly lower after treatment compared with the levels before treatment in the two groups （P 〈 0.05 ） ,but no significant differences in the levels of FPG and 2hPG were observed between the two groups both before and after the treatment （ P 〉 0.05 ）. Evaluation based on FPG, the total effective rates in metformin group and acarbose group were 87.18% and 84.06%, respectively, with no significant differ ences between the two groups （ P 〉 0.05 ）. The C/E value was 5.06 yuan in metformin group and 7.59 yuan in acarbose group. Evaluation based on 2hPG, the total effective rates in metformin group and acarbose group were 88.46% and 82.61%, respectively, with no significant differences between the two groups （P 〉0.05）. The C/E value was 4.99 yuan in metformin group and 7.73 yuan in acarbose group. Conclusion Metformin is more cost effective and in accordance with the principles of pharmacoeconomies compared with acarbose for the treatment of type 2 diabetes mellitus.