Nolly R J, Skoutakis V A
Pharmacy Services & Materials Management, University of Tennessee Medical Center/William F. Bowld Hospital, Memphis 38103.
DICP. 1989 Oct;23(10 Suppl):S23-8. doi: 10.1177/1060028089023s1004.
The cost of intravenously administered histamine2 (H2)-receptor antagonists to hospitalized patients is high. Costs can be expressed as either direct or indirect. Direct costs include drug cost, labor costs (pharmacy/nursing time), and the materials required for iv administration of these agents. Indirect costs include adverse effects, drug interactions, and allergic reactions. Due to the high percentage of total cost for labor and materials associated with the iv H2-receptor antagonists, a reduction in drug cost, although certainly desired, is unlikely to substantially reduce the amount charged the patient per intravenous dose administered or the daily cost of therapy. However, if less frequent dosing were required to achieve similar therapeutic effects, the daily therapy cost for iv H2-receptor antagonists could be substantially reduced. Assuming that cimetidine, ranitidine, and famotidine are equally effective and safe, our cost analyses at the University of Tennessee Medical Center/William F. Bowld Hospital indicate that famotidine administered q12h, regardless of the iv administration technique used, is the most cost-effective H2-receptor antagonist and is the drug of choice.
静脉注射组胺2（H2）受体拮抗剂对住院患者的成本很高。成本可分为直接成本或间接成本。直接成本包括药物成本、劳动力成本（药房/护理时间）以及静脉注射这些药物所需的材料。间接成本包括不良反应、药物相互作用和过敏反应。由于与静脉注射H2受体拮抗剂相关的劳动力和材料总成本占比很高，降低药物成本虽然肯定是人们所期望的，但不太可能大幅降低每次静脉给药向患者收取的费用或每日治疗成本。然而，如果实现相似治疗效果所需的给药频率更低，那么静脉注射H2受体拮抗剂的每日治疗成本可能会大幅降低。假设西咪替丁、雷尼替丁和法莫替丁的有效性和安全性相同，我们在田纳西大学医学中心/威廉·F·鲍尔德医院进行的成本分析表明，无论采用何种静脉给药技术，每12小时给药一次的法莫替丁是最具成本效益的H2受体拮抗剂，也是首选药物。
