PharmArchitecture Limited, 145-157 St. John Street, London, EC1V 4PY, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2011 Aug;157(2):128-35. doi: 10.1016/j.ejogrb.2011.04.009. Epub 2011 May 28.
The aim of this study was to determine the cost effectiveness of atosiban compared to betamimetics in the treatment of preterm labour within the Italian setting. A systematic literature review identified randomised controlled trials (RCTs) comparing atosiban with betamimetics. Meta-analysis of nine RCTs determined that atosiban and betamimetics had similar efficacy in delaying preterm birth by at least 48 h (p=0.910). Use of atosiban was associated with significantly fewer adverse events (p<0.008). Results demonstrate that atosiban is cost-saving versus ritodrine or isoxuprine. Atosiban cost savings are €657 per patient from the National Health Service payer's perspective; €299 at 18 h of tocolysis to €189 at 48 h from the hospital's perspective. The respective values versus isoxuprine were €303 and €199. From the combined perspective, using atosiban versus ritodrine saved from €425 to €316; and versus isoxuprine from €429 to €326. Owing to its superior safety profile, atosiban is cost-saving versus betamimetics in the treatment of preterm labour in Italy from the payer's, hospital's and combined perspectives. With the approximate 40,000 annual preterm births in Italy the annual savings could be in excess of €13 million for the payer or €3.8-6.2 million for the hospitals.
本研究旨在确定阿托西班与贝米替丁在意大利治疗早产的成本效益。系统文献回顾确定了比较阿托西班与贝米替丁的随机对照试验（RCT）。对 9 项 RCT 的荟萃分析表明，阿托西班和贝米替丁在至少延迟 48 小时的早产方面具有相似的疗效（p=0.910）。阿托西班的使用与较少的不良事件相关（p<0.008）。结果表明，阿托西班与利托君或异羟叔丁肾上腺素相比具有成本节约效益。阿托西班与利托君相比，从国家卫生服务支付者的角度来看，每个患者节省 657 欧元；从医院的角度来看，18 小时的保胎作用节省 299 欧元，48 小时节省 189 欧元。与异羟叔丁肾上腺素相比，分别节省 303 欧元和 199 欧元。从联合角度来看，与利托君相比，阿托西班的使用节省了 425 至 316 欧元；与异羟叔丁肾上腺素相比，节省了 429 至 326 欧元。由于阿托西班具有更好的安全性，因此从支付者、医院和联合角度来看，在意大利治疗早产时，阿托西班比贝米替丁具有成本节约效益。由于意大利每年大约有 40,000 例早产，因此每年的节省可能超过 1300 万欧元支付者或 380 万至 620 万欧元医院。
