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高危未筛选心肌梗死后人群中他汀类药物依从性的药物经济学影响评估:一项行政数据库引导的分析

Pharmacoeconomic impact evaluation of statin adherence in high-risk unselected post myocardial infarction population: an administrative database-guided analysis.

作者信息

Summaria Francesco, Ciaralli Fabrizio, Mustilli Marina, Sette Antonella, Lanzillo Chiara, Vasselli Loredana

机构信息

Cardiology-Policlinico Casilino, Rome, Italy.

ASL Roma B, Rome, Italy.

出版信息

Med Arch. 2013;67(5):314-7. doi: 10.5455/medarh.2013.67.314-317.

Abstract

BACKGROUND

The compliance to statins in secondary prevention is very low, increasing health-care costs principally for rehospitalization.

OBJECTIVES

To evaluate the cost of lack of persistence to statin therapy together with identification and cost-estimation of poor compliance.

METHODS

Retrospective observational study starting from administrative database analysis of statin prescription after myocardial infarction.

RESULTS

Among 463 patients enrolled, 25.1% were never treated, 70.8% received statins regularly; 14.9% received only 1-2 prescriptions (spot prescription), and 12% were occasional users. Among the 288 nonoccasional users, we found a compliance rate of 80% only in the 59.7%. The cost analysis shows that 59.787,72 euros (23.4%) have been spent for patients with compliance of less than 80% (ineffective adherence).

CONCLUSIONS

As the lower compliance affects the health-care costs, the identification of occasional users and spot prescriptions of the nonoccasional users, has a potential role in reducing medical expense with limited increase in costs.

摘要

背景

二级预防中他汀类药物的依从性很低,主要因再次住院增加了医疗保健成本。

目的

评估他汀类药物治疗持续性不足的成本,同时识别依从性差的情况并进行成本估算。

方法

从心肌梗死后他汀类药物处方的行政数据库分析开始进行回顾性观察研究。

结果

在纳入的463例患者中,25.1%从未接受治疗,70.8%规律接受他汀类药物治疗;14.9%仅接受1-2次处方(即点处方),12%为偶尔使用者。在288例非偶尔使用者中,仅59.7%的患者依从率达到80%。成本分析显示,依从性低于80%(无效依从)的患者花费了59787.72欧元(占23.4%)。

结论

由于较低的依从性影响医疗保健成本,识别偶尔使用者以及非偶尔使用者的点处方情况,在有限增加成本的情况下对降低医疗费用具有潜在作用。

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