双氯芬酸与米索前列醇固定复方制剂和其他非甾体抗炎药相比，胃肠道相关医疗资源的使用情况。

Gastrointestinal-related healthcare resource usage associated with a fixed combination of diclofenac and misoprostol versus other NSAIDs.

作者信息

Rahme E, Joseph L, Kong S X, Watson D J, Pellissier J M, LeLorier J

机构信息

Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.

出版信息

Pharmacoeconomics. 2001;19(5 Pt 2):577-88. doi: 10.2165/00019053-200119050-00011.

DOI:10.2165/00019053-200119050-00011

PMID:11465302

Abstract

OBJECTIVE

To compare gastrointestinal (GI) healthcare resource use (HCRU) and associated costs in patients taking a fixed combination of diclofenac and misoprostol versus other nonsteroidal anti-inflammatory drugs (NSAIDs).

METHODS

We analysed a sample (49,033 patients) of the Government of Quebec Health Insurance Agency database. Patients were included in the study if they did not have GI events during the year preceding the date of their first NSAID prescription dispensing (the index date). Patients were followed up for 2 years. A 3-stage model was used to determine the factors that influenced the direct medical costs of GI HCRU: (i) a logistic regression model (model 1) to estimate the risk of GI HCRU; (ii) a linear regression model (model 2) to estimate the direct costs of GI HCRU for those who had such events; (iii) multiplying the estimated risks from model 1 by the estimated costs from model 2 gave the estimated direct costs of GI HCRU for all patients.

STUDY PERSPECTIVE

Provincial government of Quebec, Canada.

RESULTS

1,533 patients were prescribed diclofenac/misoprostol at the index date and 10,540 another NSAID. Comorbidity markers were not significantly different between the 2 groups. Of the diclofenac/misoprostol patients, 23 (1.5%) were hospitalised for GI problems compared with 194 (1.8%) of the NSAID group; 403 (26.3%) of diclofenac/misoprostol patients used gastroprotective agents compared with 2,849 (27.0%) of the NSAID patients; 118 (7.7%) of diclofenac/misoprostol patients had GI diagnostic tests compared with 682 (6.5%) of the NSAID patients. The average direct medical cost of GI HCRU was 310.52 Canadian dollars ($Can)/patient (1997 values) in the diclofenac/misoprostol group compared with $Can231.19/patient (1997 values) in the NSAID group. When adjusted for baseline factors, the ratio of the total direct medical cost of GI HCRU in the diclofenac/misoprostol group to that of the NSAID group was 1.15 (95% confidence interval: 0.89, 1.48).

CONCLUSIONS

Our data showed no significant differences in GI HCRU among patients taking diclofenac/misoprostol compared with those taking NSAIDs.

摘要

目的

比较服用双氯芬酸与米索前列醇固定复方制剂的患者与服用其他非甾体抗炎药（NSAIDs）的患者的胃肠道（GI）医疗资源使用（HCRU）情况及相关费用。

方法

我们分析了魁北克省政府医疗保险机构数据库中的一个样本（49,033名患者）。如果患者在首次NSAIDs处方配药日期（索引日期）前一年没有GI事件，则纳入本研究。对患者进行了2年的随访。采用三阶段模型来确定影响GI HCRU直接医疗费用的因素：（i）逻辑回归模型（模型1）来估计GI HCRU的风险；（ii）线性回归模型（模型2）来估计发生此类事件的患者的GI HCRU直接费用；（iii）将模型1的估计风险乘以模型2的估计费用，得出所有患者的GI HCRU估计直接费用。

研究视角

加拿大魁北克省政府。

结果

在索引日期，1,533名患者被处方双氯芬酸/米索前列醇，10,540名患者被处方其他NSAIDs。两组之间的合并症指标无显著差异。在双氯芬酸/米索前列醇组患者中，23名（1.5%）因GI问题住院，而NSAIDs组为194名（1.8%）；双氯芬酸/米索前列醇组403名（26.3%）患者使用了胃保护剂，NSAIDs组为2,849名（27.0%）；双氯芬酸/米索前列醇组118名（7.7%）患者进行了GI诊断检查，NSAIDs组为682名（6.5%）。双氯芬酸/米索前列醇组GI HCRU的平均直接医疗费用为每位患者310.52加元（1997年价值），而NSAIDs组为每位患者231.19加元（1997年价值）。在对基线因素进行调整后，双氯芬酸/米索前列醇组GI HCRU的总直接医疗费用与NSAIDs组的总直接医疗费用之比为1.15（95%置信区间：0.89, 1.48）。