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综述文章:慢性肝病血小板减少症的药物经济学分析

Review article: a pharmacoeconomic analysis of thrombocytopenia in chronic liver disease.

作者信息

Brown R S

机构信息

Department of Medicine, Center for Liver Disease & Transplantation, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA.

出版信息

Aliment Pharmacol Ther. 2007 Nov;26 Suppl 1:41-8. doi: 10.1111/j.1365-2036.2007.03505.x.

Abstract

BACKGROUND

Patients with chronic liver disease commonly experience thrombocytopenia resulting from disease or treatment. Such patients often require multiple platelet transfusions, and consequently can experience associated complications including systemic infection, iron overload, and platelet refractoriness.

AIM

To discuss the limited data available on the impact of thrombocytopenia on the medical procedures and their associated costs.

RESULTS

Thrombocytopenia and its treatment can have a negative impact on outcomes and cost of therapy; costs associated with platelet transfusion can constitute a significant portion of the hospital budget. Inability to initiate or complete antiviral therapy for chronic hepatitis C infection due to low platelet counts can lead to dose reduction or discontinuation, lower efficacy, increased risks, and increased overall costs. Routine medical procedures can be complicated, prolonged, or precluded as a result of severe thrombocytopenia.

CONCLUSION

Novel therapies can safely and effectively prevent or treat thrombocytopenia in this patient population with chronic liver disease resulting in improved quality of care and significant cost savings in addition to improving treatment outcomes and quality of life (QOL) measures.

摘要

背景

慢性肝病患者常因疾病或治疗而出现血小板减少。这类患者常需多次输注血小板,因此可能会出现包括全身感染、铁过载和血小板输注无效等相关并发症。

目的

探讨关于血小板减少对医疗程序及其相关费用影响的现有有限数据。

结果

血小板减少及其治疗可能对治疗结果和费用产生负面影响;与血小板输注相关的费用可能占医院预算的很大一部分。由于血小板计数低而无法启动或完成慢性丙型肝炎感染的抗病毒治疗,可能导致剂量减少或停药、疗效降低、风险增加以及总体费用增加。严重血小板减少可使常规医疗程序变得复杂、延长或无法进行。

结论

新型疗法可安全有效地预防或治疗这类慢性肝病患者的血小板减少,除改善治疗结果和生活质量(QOL)指标外,还可提高护理质量并显著节省费用。

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