Comparative health-care cost advantage of ipratropium over tiotropium in COPD patients.
Comparative health-care cost advantage of ipratropium over tiotropium in COPD patients.
复制标题
在慢性阻塞性肺病患者中，异丙托溴铵相对于噻托溴铵的医疗费用比较优势。
DOI：
10.1016/j.jval.2011.10.014
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Carney,Greg
中科院分区：
文献类型：
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作者：
Dormuth,ColinR;Yamaguchi,Jesse;Wilmer,Brett;Hosick,David;Sturmer,Til;Carney,Greg
目的比较硫托品和异丙托品治疗患者的总直接医疗费用。方法我们在加拿大不列颠哥伦比亚省进行了一项关于医疗费用的队列研究，通过比较新患者使用硫托品和新患者使用异丙托品。研究患者的直接医疗费用是在开始吸入性抗胆碱能治疗后的头两年进行测量的。使用分位数回归估计硫托溴铵和异丙托品患者之间的直接医疗费用差异。我们根据成本分析了患者的第10个百分位数、中位数和第90个百分位数的成本差异。结果研究人群中有3140名硫托品患者和26182名异丙托品患者。在中位数和10%的患者中，观察到开始使用硫托品而不是异丙托品的患者的医疗系统成本更高。这些增长的幅度与这两种药物之间的价格差异相当。噻托溴铵和异丙托品患者的医疗系统费用在第90个百分位数中没有显著差异。结论本研究结果不支持将噻托溴铵优先于异丙托品作为节省直接医疗费用的基础。
ObjectiveTo compare the total direct health-care costs of patients treated with tiotropium and ipratropium.MethodsWe conducted a cohort study of health-care costs in British Columbia, Canada, by comparing new patients on tiotropium with new patients on ipratropium. Direct health-care costs for study patients were measured in the first 2 years after initiating inhaled anticholinergic treatment. Differences in direct health-care costs between tiotropium and ipratropium patients were estimated by using quantile regression. We analyzed cost differences in the 10th percentile, median, and 90th percentile of patients by cost. High-dimensional propensity score analysis was used as a method of adjustment for potential confounding factors.ResultsThe study population had 3,140 tiotropium patients and 26,182 ipratropium patients. Higher health system costs in patients who started on tiotropium instead of ipratropium were observed in patients in the median and 10th percentile. The magnitude of these increases was comparable to the price difference between the two drugs. Health system costs in the 90th percentile were not significantly different between tiotropium and ipratropium patients.ConclusionsThe results of this study did not support the preferential use of tiotropium over ipratropium as a basis for savings in direct health-care costs.