替诺福韦对乙型肝炎母婴阻断的成本-效果分析

doi:10.3969/j.issn.1007-3205.2024.11.016

河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (11): 1336-1341.doi: 10.3969/j.issn.1007-3205.2024.11.016

替诺福韦对乙型肝炎母婴阻断的成本-效果分析

1.南京中医药大学附属南京医院，南京市第二医院药学部，江苏南京 210003；2.南京中医药大学附属南京医院，
南京市第二医院妇产科，江苏南京 210003；3.南京中医药大学附属南京医院，南京市第二医院信息科，江苏
南京 210003；4.南京中医药大学附属南京医院，南京市第二医院Ⅰ期临床研究中心，江苏南京 210003

出版日期:2024-11-25 发布日期:2024-11-26
作者简介:焦放（1988-），女，山西襄垣人，南京中医药大学附属南京医院药师，医学硕士，从事临床药学研究。
基金资助:
江苏省自然科学基金项目（BK20230157）；南京药学会-常州四药医院药学科研基金项目（2019YX022）

Cost-effectiveness analysis of tenofovir in blocking mother-to-child transmission of hepatitis B

1.Department of Pharmacy, the Second Hospital of Nanjing City/Nanjing Affiliated Hospital of Nanjing
University of Traditional Chinese Medicine, Jiangsu Province, Nanjing 210003, China; 2.Department of
Obstetrics, the Second Hospital of Nanjing City/Nanjing Affiliated Hospital of Nanjing University of
Traditional Chinese Medicine, Jiangsu Province, Nanjing 210003, China; 3.Department of
Information, the Second Hospital of Nanjing City/Nanjing Affiliated Hospital of Nanjing
University of Traditional Chinese Medicine, Jiangsu Province, Nanjing 210003, China;
4.Department of Phase I Clinical Research Center, the Second Hospital of Nanjing
City/Nanjing Affiliated Hospital of Nanjing University of Traditional
Chinese Medicine, Jiangsu Province, Nanjing 210003, China

Online:2024-11-25 Published:2024-11-26

摘要/Abstract

摘要： 目的评价国产与进口替诺福韦对乙型肝炎（hepatitis B vireus，HBV）母婴阻断的成本-效果。
方法筛选于南京市第二医院妇产科治疗且分娩的高载HBV妊娠患者，回顾性分析国产与进口替诺福韦在HBV母婴阻断中的临床疗效，采用成本-效果分析方法计算增量成本效果比，进行敏感性分析。
结果符合入组标准的患者共计179例，国产组131例，进口组48例。国产组与进口组患者HBV DNA转阴率分别为45.04%和52.08%，HBV母婴阻断有效率分别为98.47%和100.00%，差异均无统计学意义（P＞0.05）。国产组与进口组治疗总成本分别为（20 313.73±11 467.36）元和（20 906.19±6 211.43）元，差异无统计学意义（P＞0.05）；药品费用分别为（47.53±8.07）元和（1 118.62±200.89）元，国产组显著低于进口组（P＜0.05）。国产组对比进口组的增量成本效果比为700.05，小于意愿支付阈值；敏感性分析与原分析结果一致。
结论国产与进口替诺福韦在进行HBV母婴阻断时的阻断有效率相当，而国产替诺福韦更具药物经济学优势，临床上建议根据患者实际需求合理选择药物。

关键词: 乙型肝炎, 替诺福韦, 母婴阻断

Abstract: Objective To evaluate the cost-effectiveness of domestic and imported tenofovir in blocking mother-to-child transmission of hepatitis B virus (HBV).
Methods Pregnant patients with high HBV load who were treated and delivered at the Department of Obstetrics and Gynecology in the Second Hospital of Nanjing were enrolled in this study. A retrospective analysis was conducted to analyze clinical efficacy of domestic and imported tenofovir for mother-to-child transmission of HBV. The incremental cost-effectiveness ratio and sensitivity analysis was performed based on cost-effectiveness analysis.
Results A total of 179 patients met the inclusion criteria, including 131 patients in the domestic group and 48 patients in the imported group. The positive-to-negative conversion rates of HBV DNA were 45.04% and 52.08% in the domestic group and the imported group respectively, while the rates of blocking mother-to-child transmission of HBV were 98.47% and 100.00% respectively, exhibiting no statistical significance (P＞0.05). The total treatment costs of the domestic and imported groups were (20 313.73±11 467.36) yuan and (20 906.19±6 211.43) yuan, respectively, which did not demonstrate statistical significance (P＞0.05), either. The drug expense of domestic group was observed to be significantly lower compared with its counterpart ［(47.53±8.07) yuan vs. (1 118.62±200.89) yuan, P＜0.05］. The incremental cost-effectiveness ratio of the domestic group and the imported group was 700.05, which was lower than the willing payment threshold of our country. This result was validated by sensitivity analysis.
Conclusion The efficacy of domestic tenofovir is consistent with its imported counterpart on blocking mother-to-child transmission of hepatitis B, while the former has more pharmacoeconomic advantages. Consequently, it is recommended to select drugs rationally according to the practical requirements of patients in clinical practice.

Key words: hepatitis B, tenofovir, blocking mother-to-child transmission

焦放1, 杨大为1, 岳欣2, 曹慧2, 纪亚亮3, 许青云4. 替诺福韦对乙型肝炎母婴阻断的成本-效果分析 [J]. 河北医科大学学报, 2024, 45(11): 1336-1341.

JIAO Fang1, YANG Da-wei1, YUE Xin2, CAO Hui2, JI Ya-liang3, XU Qing-yun4. Cost-effectiveness analysis of tenofovir in blocking mother-to-child transmission of hepatitis B [J]. Journal of Hebei Medical University, 2024, 45(11): 1336-1341.

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替诺福韦对乙型肝炎母婴阻断的成本-效果分析

Cost-effectiveness analysis of tenofovir in blocking mother-to-child transmission of hepatitis B

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