法国奥氮平与氟哌啶醇治疗精神分裂症的经济学比较

[Economic comparison of olanzapine versus haloperidol in treatment of schizophrenia in France].

作者信息

Le Pen C, Lilliu H, Allicar M P, Olivier V, Gregor K J

机构信息

CLP-Santé, Paris.

出版信息

Encephale. 1999 Jul-Aug;25(4):281-6.

PMID:10546082

Abstract

PURPOSE

The purpose of this study is to provide an economic comparison of olanzapine-treated and haloperidol-treated patients from the subset of French patients who participated in a large, international, randomised clinical trial in schizophrenia.

METHODS

Patients were evaluated from randomisation until discontinuation, drop out or completion of the 52-week study. The primary clinical measure was "clinically important response" (derived from BPRS total scores). The secondary measure was "clinically important improvement" (derived from CGI severity of illness scores). The primary economic measure was mean per diem, per patient total direct medical costs.

RESULTS

A total of 275 French patients where included in the study. Demographics and other baseline differences between olanzapine- and haloperidol-treated patients were not statistically significant. Olanzapine-treated patients (205 +/- 142 days) experienced significantly (p < 0.001) longer evaluation periods than haloperidol-treated patients (132 +/- 129 days). Olanzapine-treated patients (54%) were significantly (p = 0.03) more likely to experience a clinically important response than haloperidol-treated patients (40%). Olanzapine-treated patients (69%) were significantly (p = 0.02) more likely to experience clinically important improvement than haloperidol-treated patients (54%). The mean per diem, per patient total direct medical cost was statistically lower (p = 0.033) for olanzapine-treated patients (FF619 +/- 509) compared to haloperidol-treated patients (FF756 +/- 478).

CONCLUSION

Olanzapine treatment was associated with significantly better clinical outcomes and per diem total direct medical cost than haloperidol treatment. The findings indicate that olanzapine is dominant compared to haloperidol for the treatment of schizophrenia, in the context of analysed data. These findings produce increased relevance in France to the existing evidence supporting olanzapine's cost and effectiveness profiles.

摘要

目的

本研究旨在对参与一项大型国际精神分裂症随机临床试验的法国患者亚组中接受奥氮平治疗和接受氟哌啶醇治疗的患者进行经济学比较。

方法

对患者从随机分组开始直至52周研究结束、退出或完成进行评估。主要临床指标为“具有临床意义的反应”（源自简明精神病评定量表总分）。次要指标为“具有临床意义的改善”（源自临床总体印象疾病严重程度评分）。主要经济学指标为每位患者每日的平均直接医疗总费用。

结果

共有275名法国患者纳入研究。接受奥氮平治疗和接受氟哌啶醇治疗的患者在人口统计学和其他基线差异方面无统计学意义。接受奥氮平治疗的患者（205±142天）的评估期显著长于接受氟哌啶醇治疗（132±129天）的患者（p<0.001）。接受奥氮平治疗的患者（54%）出现具有临床意义反应的可能性显著高于接受氟哌啶醇治疗的患者（40%）（p=0.03）。接受奥氮平治疗的患者（69%）出现具有临床意义改善的可能性显著高于接受氟哌啶醇治疗的患者（54%）（p=0.02）。接受奥氮平治疗的患者（619±509法郎）的每位患者每日平均直接医疗总费用在统计学上低于接受氟哌啶醇治疗的患者（756±478法郎）（p=0.033）。