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吉兰-巴雷综合征治疗的药物经济学:血浆置换与静脉注射免疫球蛋白

Pharmacoeconomics of therapy for Guillain-Barré syndrome: plasma exchange and intravenous immunoglobulin.

作者信息

Tsai Ching-Piao, Wang Kai-Chen, Liu Chih-Yang, Sheng Wen-Yung, Lee Tzu-Chi

机构信息

Neurology, The Neurological Institute, Taipei Veterans General Hospital and Taipei City Hospital, 201, Sec. 2 Shih-Pai Road, Taipei 112, Taiwan.

出版信息

J Clin Neurosci. 2007 Jul;14(7):625-9. doi: 10.1016/j.jocn.2006.03.020.

Abstract

Guillain-Barré syndrome (GBS) is an acute neuropathy and a clinical syndrome that includes a number of pathological and electrophysiological subtypes. Intravenous immunoglobulin (IVIG) and plasma exchange (PE) are both equally efficacious for the treatment of GBS; however, the cost of IVIG may be lower for both the patient and the healthcare system. To compare the pharmacoeconomics of PE and IVIG in GBS, a retrospective study was done from 1999 to 2004, which included a total of 24 patients with GBS who were admitted to Taipei Veterans General Hospital. This showed that except for the costs of the drugs used in IVIG, treatment of GBS with IVIG was more cost-effective (p=0.057) than that with PE in total length of hospitalization and the cost of procedures and hospitalization. The study also showed that the total costs were higher for patients on ventilators than those not requiring ventilators (p=0.008, t-test) and the length of hospitalization showed a very strong linear relationship to total costs (Pearson correlation coefficient=0.907). The regression analysis showed that each additional day of hospitalization increased the hospitalization costs by an average of 5599 New Taiwan Dollars (NT) (US$1.00=NT$33.50 in 2005).

摘要

吉兰-巴雷综合征(GBS)是一种急性神经病,是一种包括多种病理和电生理亚型的临床综合征。静脉注射免疫球蛋白(IVIG)和血浆置换(PE)对GBS的治疗同样有效;然而,IVIG对患者和医疗系统的成本可能更低。为比较PE和IVIG治疗GBS的药物经济学,对1999年至2004年进行了一项回顾性研究,该研究共纳入了24例入住台北荣民总医院的GBS患者。结果显示,除IVIG所用药物成本外,在住院总时长、操作和住院成本方面,IVIG治疗GBS比PE更具成本效益(p=0.057)。该研究还表明,使用呼吸机的患者总费用高于无需使用呼吸机的患者(p=0.008,t检验),且住院时长与总费用呈现非常强的线性关系(Pearson相关系数=0.907)。回归分析显示,住院时间每增加一天,住院费用平均增加5599新台币(2005年1美元=33.50新台币)。

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