抗菌药物在美国结核病预防和治疗中的价值。

SRI International, Center for Health Sciences, Menlo Park, California 94025, USA.

Int J Tuberc Lung Dis. 2002 Apr;6(4):275-88.

OBJECTIVE

To estimate the economic value of antimicrobials for the prevention and treatment of tuberculosis in the United States from 1954 through 1997.

DESIGN

Published sources were used to estimate the burden of illness (direct medical costs, reductions in quality of life, and years of life lost) from active tuberculosis (TB) cases diagnosed between 1954 and 1997. Published literature concerning the pre-antimicrobial incidence rate and treatment of TB were extrapolated to estimate the burden of illness that would have occurred in the absence of antimicrobials.

RESULTS

Between 1954 and 1997, the use of antimicrobials reduced the number of newly diagnosed cases of active TB by 32% (relative to the number that would have occurred in the absence of antimicrobials), the number of mortalities by 81%, the number of life-years lost by 87%, and the cost of medical treatment by 76%. The total financial burden of illness over this time period (including the value of lost life-years) was reduced from $894 billion (in 1997 dollars) to $128 billion.

CONCLUSION

TB antimicrobials had a substantial health impact in the US from 1954 to 1997. This quantitative assessment of the economic impact of innovative biopharmaceutical products demonstrates the importance of continuing medical innovation.

目的

评估1954年至1997年期间抗菌药物在美国预防和治疗结核病的经济价值。

设计

利用已发表的资料估算1954年至1997年期间确诊的活动性肺结核（TB）病例的疾病负担（直接医疗费用、生活质量下降和生命年损失）。有关抗微生物药物出现之前结核病发病率和治疗情况的已发表文献被用来推断在没有抗菌药物的情况下可能发生的疾病负担。

结果

1954年至1997年期间，抗菌药物的使用使新确诊的活动性肺结核病例数减少了32%（相对于没有抗菌药物时可能出现的病例数），死亡人数减少了81%，生命年损失数减少了87%，医疗费用降低了76%。在此期间疾病的总经济负担（包括生命年损失的价值）从8940亿美元（按1997年美元计算）降至1280亿美元。