Langtry H D, Palmer K J, Benfield P
Adis International Limited, Auckland, New Zealand.
Pharmacoeconomics. 1993 Apr;3(4):309-37. doi: 10.2165/00019053-199303040-00006.
In patients with human immunodeficiency virus (HIV) infections or the acquired immunodeficiency syndrome (AIDS), zidovudine is a first-line therapy that reduces morbidity and may reduce mortality. By delaying progression to AIDS, the drug reduces the duration and incidence of hospitalisations in a given time period, resulting in overall decreases in the cost of medical treatment per unit of survival time. In current therapeutic dosages zidovudine is generally well tolerated. Most pharmacoeconomic and quality-of-life studies of this agent were conducted using data relating to higher dosages and higher drug acquisition costs than those currently applicable, but nevertheless generally support the cost-effectiveness of zidovudine in patients with HIV disease. Studies examining the use of the drug in higher dosages demonstrate neither clear positive nor negative effects of the drug on quality of life. The cost effectiveness of the drug as prophylaxis against seroconversion after occupational exposure to HIV is dependent primarily on the establishment of clinical effectiveness in this condition. Further pharmacoeconomic studies should examine changes to dosage and cost factors, along with direct nonmedical treatment costs, indirect medical treatment costs and the effects of the drug on quality of life. An evaluation of existing studies suggests that if these factors were accounted for, zidovudine might be shown to be more clearly cost effective, and indeed its use in the treatment of patients with HIV disease might be found to result in cost savings.
对于感染人类免疫缺陷病毒（HIV）或患有获得性免疫缺陷综合征（AIDS）的患者，齐多夫定是一种一线治疗药物，可降低发病率并可能降低死亡率。通过延缓病情发展至艾滋病，该药物可减少特定时间段内的住院时间和住院率，从而使单位生存时间的医疗费用总体下降。在当前的治疗剂量下，齐多夫定通常耐受性良好。关于该药物的大多数药物经济学和生活质量研究使用的数据所涉及的剂量和药物购置成本均高于目前适用的水平，但总体上仍支持齐多夫定在HIV疾病患者中的成本效益。研究高剂量使用该药物的情况表明，该药物对生活质量既无明显的积极影响也无明显的消极影响。该药物作为职业暴露于HIV后预防血清转化的成本效益主要取决于在这种情况下临床有效性的确立。进一步的药物经济学研究应考察剂量和成本因素的变化，以及直接非医疗治疗成本、间接医疗治疗成本和该药物对生活质量的影响。对现有研究的评估表明，如果考虑这些因素，齐多夫定可能会更明显地显示出成本效益，实际上，其用于治疗HIV疾病患者可能会节省成本。
