Knill-Jones R, Drummond M, Kohli H, Davies L
Department of Public Health, University of Glasgow, UK.
Postgrad Med J. 1990 Aug;66(778):639-46. doi: 10.1136/pgmj.66.778.639.
This study assesses the economic benefits of misoprostol in the prophylaxis of gastric ulcers larger than 0.3 cm in patients with osteoarthritis receiving non-steroidal anti-inflammatory drugs. Independent epidemiological data were obtained for patients in Scotland and the West Midlands. Co-diagnosis of arthritis with gastric ulcer recorded in the routine data was substantially less (4% Scotland, 10% West Midlands) than the 21% found at case review. These data were combined with cost and patient management data in a decision analysis model to explore whether prophylactic use of misoprostol altered substantially the average cost of managing gastric ulcer. Using conservative assumptions and a daily dose of 400 micrograms, cost savings per patient to the National Health Service of 5-8 pounds over a 3-month period are expected in the groups of patients studied, while at the 800 micrograms dose there would be a net cost of 23-25 pounds. Sensitivity analysis showed that under many assumptions misoprostol is expected to be cost saving or cost neutral.
本研究评估了米索前列醇在预防骨关节炎患者使用非甾体抗炎药时发生的大于0.3厘米胃溃疡方面的经济效益。获取了苏格兰和西米德兰兹郡患者的独立流行病学数据。常规数据中记录的关节炎合并胃溃疡的共诊断率（苏格兰为4%，西米德兰兹郡为10%）远低于病例复查时发现的21%。这些数据与成本和患者管理数据相结合，纳入一个决策分析模型，以探讨预防性使用米索前列醇是否会大幅改变胃溃疡管理的平均成本。采用保守假设并每日剂量为400微克时，在所研究的患者组中，预计在3个月期间每位患者可为英国国家医疗服务体系节省5至8英镑的成本，而每日剂量为800微克时，净成本将为23至25英镑。敏感性分析表明，在许多假设条件下，预计米索前列醇可节省成本或成本持平。
