Slof J, Badia X, Lainez-Andres J M, Galvan J, Heras J
Universidad Autónoma de Barcelona, Bellaterra.
Neurologia. 2005 Jul-Aug;20(6):290-8.
Although adverse events of triptans are usually not important from a clinical point of view, they can worry patients and lead them to consume healthcare resources.
A decision analytic model was used to represent the behavior and management of patients who suffered adverse events after taking a triptan. Using data about the incidence of adverse events, the behavior and management of patients, and the unit cost of the healthcare resource consumed, the costs of treating adverse events were calculated, as was the iatrogenic cost factor of the triptans available in Spain.
10 % to 20 % of patients who suffer a chest or CNS-related adverse advent related to triptan use seek medical attention. The management cost of a chest-related event was estimated to be euros 66,43, euros 33,09, or euros 137,01, depending on whether the patient consulted a neurologist, a primary care physician, or a hospital emergency department. For CNS-related events the management cost was estimated to be euros 52,88, euros 16,89 or euros 102,17, respectively. Excluding the placebo effect, the resulting iatrogenic cost factor varied between 1 for almotriptan 12,5 mg and 1,21 for zolmitriptan 2,5 mg. In absolute values, the average cost per patient (above placebo) varied between 0 euros for almotriptan 12,5 mg and euros 1,17 for eletriptan 80 mg.
The management of adverse events can add substantial costs to a treatment with triptans. These costs vary considerably between triptans due to differences in the incidence of adverse events. Lowest costs were found for almotriptan 12,5 mg.
尽管从临床角度来看,曲坦类药物的不良事件通常并不严重,但它们会使患者担忧并导致其消耗医疗资源。
采用决策分析模型来描述服用曲坦类药物后出现不良事件的患者的行为和管理情况。利用不良事件发生率、患者行为和管理情况以及所消耗医疗资源的单位成本等数据,计算了不良事件的治疗成本以及西班牙市场上现有曲坦类药物的医源性成本因素。
10%至20%因使用曲坦类药物而出现胸部或中枢神经系统相关不良事件的患者会寻求医疗救治。根据患者咨询的是神经科医生、初级保健医生还是医院急诊科,胸部相关事件的管理成本估计分别为66.43欧元、33.09欧元或137.01欧元。对于中枢神经系统相关事件,管理成本估计分别为52.88欧元、16.89欧元或102.17欧元。排除安慰剂效应后,所产生的医源性成本因素在阿洛替普坦12.5毫克时为1,在佐米曲普坦2.5毫克时为1.21。以绝对值计算,每位患者(高于安慰剂)的平均成本在阿洛替普坦12.5毫克时为0欧元,在依来曲普坦80毫克时为1.17欧元。
不良事件的管理会给曲坦类药物治疗增加大量成本。由于不良事件发生率的差异,这些成本在不同曲坦类药物之间有很大差异。阿洛替普坦12.5毫克的成本最低。