A cost decision analysis of 4 tocolytic drugs
A cost decision analysis of 4 tocolytic drugs
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DOI：
10.1016/j.ajog.2007.06.052
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发表时间：
2007-10-01
影响因子：
9.8
通讯作者：
Baxter, Jason
中科院分区：
文献类型：
--
作者：
Hayes, Edward;Moroz, Leslie;Baxter, Jason
目的：本研究的目的是根据成本决策分析确定最佳的宫缩抑制剂。研究设计：对常用的宫缩抑制剂进行 PubMed 搜索，以确定不良事件的概率。药剂的成本由采购成本以及不良事件的概率和成本决定。构建决策树以确定哪种宫缩抑制剂的总成本最低，并进行随后的敏感性分析。结果：总共有 19 项临床试验，涉及 1073 名患者（吲哚美辛，176 名患者；硫酸镁，451 名患者；硝苯地平，176 名患者；特布他林，270 名患者）。特布他林的不良事件概率为 57.9%，硫酸镁为 22.0%，硝苯地平为 27.2%，吲哚美辛为 11.4%。由于监测和治疗不良事件的成本，与硫酸镁（197.90 美元）和特布他林（399.02 美元）相比，硝苯地平（16.75 美元）和吲哚美辛（15.40 美元）是最便宜的治疗选择。 结论：如果选择宫缩抑制剂，根据成本决策分析，硝苯地平和吲哚美辛都应该是首选药物。
OBJECTIVE: The purpose of this study was to determine the optimal tocolytic agent, based on a cost decision analysis.STUDY DESIGN: A PubMed search of commonly used tocolytics was performed to determine the probability of adverse events. Cost for an agent was determined by acquisition cost and the probability and cost of adverse events. A decision tree was constructed to determine which tocolytic had the lowest total costs, with subsequent sensitivity analysis.RESULTS: A total of 19 clinical trials combined for a cohort of 1073 patients ( indomethacin, 176 patients; magnesium sulfate, 451 patients; nifedipine, 176 patients; and terbutaline, 270 patients). The probability of adverse events was 57.9% for terbutaline, 22.0% for magnesium sulfate, 27.2% for nifedipine, and 11.4% for indomethacin. Nifedipine ($ 16.75) and indomethacin ($ 15.40) were the least expensive treatment options, compared with magnesium sulfate ($ 197.90) and terbutaline ($ 399.02) because of the cost of monitoring and treating adverse events.CONCLUSION: If one elects a tocolytic, both nifedipine and indomethacin should be the agents of choice, based on a cost decision analysis.