Walsh C, Murphy A, Kirby A, Vaughan C
Ir Med J. 2014 May;107(5):133-5.
In Ireland, there are four anticoagulants available for prescribing to patients with atrial fibrillation for stroke prevention. A key feature of the three most recent anticoagulants is that monitoring is redundant. Despite this, there is continued prescribing of the incumbent anticoagulant, warfarin, which requires monitoring. Lack of information regarding the cost of monitoring, and the extra burden it places on health budgets and patients, motivated this costing study. Using micro costing, the costs of warfarin treatment (including monitoring) was disaggregated and isolated from both the patients' and health care provider's perspectives in a Cork hospital. Costs to the health care provider per patient per clinic visited were 21.57 Euros. Patient costs incurred per patient per clinic were 48.50 Euros. Thus, the total costs per patient per visit were 70.07 Euros. This result reveals that while the pharmaceutical cost of warfarin is low; it is not an inexpensive therapy when monitoring costs are considered.
在爱尔兰，有四种抗凝剂可用于给心房颤动患者开出处方以预防中风。最近三种抗凝剂的一个关键特征是无需监测。尽管如此，仍在持续开具需要监测的现有抗凝剂华法林。缺乏关于监测成本及其给卫生预算和患者带来的额外负担的信息，促使开展了这项成本核算研究。采用微观成本核算方法，从科克一家医院的患者和医疗服务提供者的角度，对使用华法林治疗的成本（包括监测成本）进行了分解和分离。每次门诊每位患者给医疗服务提供者带来的成本为21.57欧元。每次门诊每位患者产生的患者成本为48.50欧元。因此，每次门诊每位患者的总成本为70.07欧元。这一结果表明，虽然华法林的药物成本较低，但考虑到监测成本，它并非一种廉价的治疗方法。
