Kang Hye-Young, Cho Woohyun, Lee Sunmi, Kim Hyung-Jong, Lee Ho Yong, Woo Tae-Wook
Graduate School of Public Health, Yonsei University.
J Prev Med Public Health. 2006 Mar;39(2):149-58.
We wanted to evaluate the economic value of a pharmaceutical product, Kremezin, for treating patients with chronic renal failure (CRF) by estimating the amount of cost savings due to its effect for delaying the initiation of dialysis treatments.
We defined a conventional treatment for CRF accompanied by Kremezin therapy as 'the treatment group' and only conventional treatment as 'the alternative group.' The types of costs included were direct medical and non-medical costs and costs of productivity loss. The information on the effect of Kremezin was obtained from the results of earlier clinical studies. Cost information was derived from the administrative data for 20 hemodialysis and 20 peritoneal dialysis patients from one tertiary care hospital, and also from the administrative data of 10 hemodialysis patients from one free-standing dialysis center. Per-capita cost savings resulting from Kremezin therapy were separately estimated for the cases with delay for the onset of hemodialysis and the cases with immediate performance of peritoneal dialysis. By computing the weighted average for the cases of hemodialysis and peritoneal dialysis, the expected per-capita cost savings of a patient with CRF was obtained. Using a discount rate of 5%, future cost savings were converted to the present value.
The present value of cumulative cost savings per patient with CRF from the societal perspective would be 18,555,000-29,410,000 Won or 72,104,000-112,523,000 Won if Kremezin delays the initiation of dialysis by 1 or 4 years.
The estimated amount of cost savings resulting from treating CRF patients with Kremezin confirms that its effect for delaying the onset of dialysis treatments has a considerable economic value.
我们希望通过估算因延缓透析治疗起始时间而节省的成本金额,来评估一种药品科瑞明(Kremezin)治疗慢性肾衰竭(CRF)患者的经济价值。
我们将伴有科瑞明治疗的慢性肾衰竭常规治疗定义为“治疗组”,仅采用常规治疗定义为“对照组”。所纳入的成本类型包括直接医疗成本、非医疗成本以及生产力损失成本。科瑞明疗效的信息来自早期临床研究结果。成本信息源自一家三级护理医院20例血液透析患者和20例腹膜透析患者的管理数据,以及一家独立透析中心10例血液透析患者的管理数据。分别针对血液透析起始时间延迟和立即进行腹膜透析的情况,估算科瑞明治疗带来的人均成本节省。通过计算血液透析和腹膜透析病例的加权平均值,得出慢性肾衰竭患者的预期人均成本节省。使用5%的贴现率,将未来成本节省换算为现值。
从社会角度来看,如果科瑞明将透析起始时间延迟1年或4年,慢性肾衰竭患者人均累积成本节省的现值将为18555000 - 29410000韩元或72104000 -
112523000韩元。
用科瑞明治疗慢性肾衰竭患者所估算的成本节省金额证实,其延缓透析治疗起始时间的效果具有相当大的经济价值。