Adibe Maxwell O, Aguwa Cletus N, Ukwe Chinwe V
Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu, Nigeria; Pharmacotherapeutic Group, Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu, Nigeria.
Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu, Nigeria; Pharmacotherapeutic Group, Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu, Nigeria.
Value Health Reg Issues. 2013 Sep-Oct;2(2):189-198. doi: 10.1016/j.vhri.2013.06.009. Epub 2013 Sep 13.
To assess the cost-effectiveness of pharmaceutical care (PC) intervention versus usual care (UC) in the management of type 2 diabetes.
This study was a randomized, controlled study with a 12-month patient follow-up in two Nigerian tertiary hospitals. One hundred and ten patients were randomly assigned to each of the "intervention" (PC) and the "control" (UC) groups. Patients in the UC group received the usual/conventional care offered by the hospitals. Patients in the PC group received UC and PC in the form of structural self-care education and training for 12 months. The economic evaluation was based on patients' perspective. Costs of management of individual complications were calculated from activities involved in their management by using activity-based costing. The impact of the interventions on quality of life was estimated by using the HUI23S4EN.40Q (Mark index 3) questionnaire. The primary outcomes were incremental cost-utility ratio and net monetary benefit. An intention-to-treat approach was used. Two-sample comparisons were made by using Student's t tests for normally distributed variables data at baseline, 6 months, and 12 months. Comparisons of proportions were done by using the chi-square test.
The PC intervention led to incremental cost and effect of Nigerian naira (NGN) 10,623 ($69) and 0.12 quality-adjusted life-year (QALY) gained, respectively, with an associated incremental cost-utility ratio of NGN 88,525 ($571) per QALY gained. In the cost-effectiveness acceptability curve, the probability that PC was more cost-effective than UC was 95% at the NGN 250,000 ($1613) per QALY gained threshold and 52% at the NGN 88,600 ($572) per QALY gained threshold.
The PC intervention was very cost-effective among patients with type 2 diabetes at the NGN 88,525 ($571.13) per QALY gained threshold, although considerable uncertainty surrounds these estimates.
评估药物治疗（PC）干预与常规治疗（UC）在2型糖尿病管理中的成本效益。
本研究为一项随机对照研究，在两家尼日利亚三级医院对患者进行了为期12个月的随访。110名患者被随机分配到“干预”（PC）组和“对照”（UC）组。UC组患者接受医院提供的常规/传统治疗。PC组患者在接受UC的基础上，还接受了为期12个月的结构化自我护理教育和培训形式的PC。经济评估基于患者视角。通过作业成本法，根据管理个体并发症所涉及的活动计算管理成本。使用HUI23S4EN.40Q（Mark指数3）问卷评估干预对生活质量的影响。主要结局为增量成本效用比和净货币效益。采用意向性分析方法。对于基线、6个月和12个月时呈正态分布的变量数据，使用学生t检验进行两组比较。比例比较采用卡方检验。
PC干预分别导致增量成本为10,623尼日利亚奈拉（NGN）（69美元），效果为获得0.12质量调整生命年（QALY），每获得一个QALY的相关增量成本效用比为NGN 88,525（571美元）。在成本效益可接受性曲线中，在每获得一个QALY阈值为NGN 250,000（1613美元）时，PC比UC更具成本效益的概率为95%；在每获得一个QALY阈值为NGN 88,600（572美元）时，该概率为52%。
在每获得一个QALY阈值为NGN 88,525（5
