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[抗精神病药物的使用与成本]

[Consumption and cost of antipsychotic drugs].

作者信息

Pérez J, Marín N, Vallano A, Castells X, Capellà D

机构信息

Fundació Institut Català de Farmacologia, Servicio de Farmacología Clínica, Hospital Universitario Vall d'Hebron, Universidad Autònoma, Barcelona.

出版信息

Actas Esp Psiquiatr. 2005 Mar-Apr;33(2):110-6.

Abstract

INTRODUCTION

In recent years, new atypical antipsychotic drugs have been marketed. This study aims to analyze the evolution of the consumption pattern and pharmaceutical cost of the antipsychotic drugs during the last years and the impact that the new atypical antipsychotic drugs have had.

METHODS

Based on the ECOM database of the Ministry of Health and Consumer Affairs of Spain, the sales data of the antipsychotic drugs in Catalonia during the 1990-2001 period have been chosen. The drugs have been classified into typical or classical and atypical. Consumption data have been expressed in daily defined dose (DDD) per 1,000 inhabitants and per day of treatment (DID), and cost data in constant euros.

RESULTS

Antipsychotic consumption increased from 3.31 DID in 1990 to 6.04 DID in 2001. Typical drugs consumption decreased (from 100 % consumption in 1990 to 46 % in 2001) and that of the atypical ones increased (from 1% consumption in the year 1993 to 54% in the year 2001). A change in the use pattern of different drugs is verified. In the year 1990, the most consumed drugs were flupenthixol (0.86 DID) and haloperidol (0.67 DID), and in the year 2001 olanzapine (1.69 DID) and risperidone (1.30 DID). The drugs with a greater increase in consumption were olanzapine, which multiplied its consumption five fold from 1997 to 2001 and risperidone, which multiplied it by 20 from 1994 to 2001. During the study period, the cost increased 13 times, above all due to increase in cost of atypical antipsychotics (from less than 1 % of the total cost in 1993 to 92 % of the total cost in 2001). The DDD cost of antipsychotics increased (6.48 euros in 1990 and 20.31 euros in 2001). However, that of the typical antipsychotics decreased (6.48 euros in 1990 and 4.62 euros in 2001) and that of the atypical ones increased (2.06 euros in 1993 and 15.69 euros in 2001).

CONCLUSION

The marketing of the new atypical antipsychotic drugs has had an extraordinary impact on antipsychotic drug consumption and cost. The cost/effectiveness ratio of the new atypical antipsychotic drugs in the clinical practice should be evaluated to determine the economic resources aimed at costs of the different antipsychotic drugs.

摘要

引言

近年来,新型非典型抗精神病药物已投放市场。本研究旨在分析过去几年抗精神病药物消费模式和药物成本的演变,以及新型非典型抗精神病药物所产生的影响。

方法

基于西班牙卫生与消费者事务部的ECOM数据库,选取了1990 - 2001年加泰罗尼亚地区抗精神病药物的销售数据。这些药物被分为典型或传统型以及非典型。消费数据以每1000居民每日限定剂量(DDD)和每日治疗剂量(DID)表示,成本数据以恒定欧元表示。

结果

抗精神病药物消费量从1990年的3.31 DID增加到2001年的6.04 DID。典型药物的消费量下降(从1990年的100%降至2001年的46%),而非典型药物的消费量增加(从1993年的1%增至2001年的54%)。不同药物的使用模式发生了变化。1990年,消费最多的药物是三氟噻吨(0.86 DID)和氟哌啶醇(0.67 DID),2001年则是奥氮平(1.69 DID)和利培酮(1.30 DID)。消费量增长幅度较大的药物是奥氮平,其消费量在1997年至2001年间增长了五倍,利培酮在1994年至2001年间增长了20倍。在研究期间,成本增长了13倍,主要是由于非典型抗精神病药物成本的增加(从1993年占总成本的不到1%增至2001年的92%)。抗精神病药物的DDD成本增加(1990年为6.48欧元,2001年为20.31欧元)。然而,典型抗精神病药物的成本下降(1990年为6.48欧元,2001年为4.62欧元),非典型药物的成本增加(1993年为2.06欧元,2001年为15.69欧元)。

结论

新型非典型抗精神病药物的上市对抗精神病药物的消费和成本产生了显著影响。应评估新型非典型抗精神病药物在临床实践中的成本效益比,以确定针对不同抗精神病药物成本的经济资源。

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