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从法国社会角度评估非瓣膜性心房颤动患者维生素K拮抗剂治疗的成本。

Estimation of the costs attributable to vitamin K antagonist treatment in patients with non-valvular atrial fibrillation from a French societal perspective.

作者信息

Levy Pierre, Smadja David, Dorey Julie, Toumi Mondher, Meinecke Anna-Katharina, Bowrin Kevin, Briere Jean-Baptiste

机构信息

Department of Economics and Management of Health Organisations, The University of Paris Dauphine, Paris, France.

Department of Medicine, The University of Paris Descartes, Paris, France.

出版信息

J Mark Access Health Policy. 2019 Feb 1;7(1):1564506. doi: 10.1080/20016689.2018.1564506. eCollection 2019.

DOI:10.1080/20016689.2018.1564506
PMID:30788086
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6374971/
Abstract

: Little is known about the costs associated with vitamin K antagonist (VKA) treatment in patients with non-valvular atrial fibrillation (NVAF) in France. : To evaluate monthly per-patient costs attributable to VKA treatment in NVAF patients from a French societal perspective. : Retrospective data were obtained from 7 international normalised ratio (INR) monitoring centres in France. Patients older than 18 years of age with NVAF treated with VKA were recruited. Additional patient-level data assessing resource use corresponding with VKA treatment were collected via self-completed questionnaires. Unit costs applicable to 2015 were multiplied by resource use and summed to generate VKA treatment costs. : 363 patients were included; 53% were men. The majority of patients received fluindione (72%). The number of INR tests per patient per month was 1.69 (95% CI, 1.59-1.80). The monthly patient cost was €39.72 (€36.23-43.21) from the French societal perspective. Direct medical costs comprised 76% of overall costs, with drug costs representing 7.4% (€2.4); direct non-medical and indirect costs comprised 10% and 14% respectively. : Costs associated with VKA treatment in NVAF cannot be estimated only with drug costs. When direct and indirect attributable costs associated with VKA treatment are considered, the VKA treatment costs are more substantial.

摘要

在法国,对于非瓣膜性心房颤动(NVAF)患者使用维生素K拮抗剂(VKA)治疗的相关成本了解甚少。

从法国社会角度评估NVAF患者VKA治疗的每月人均成本。

从法国7个国际标准化比值(INR)监测中心获取回顾性数据。招募年龄超过18岁、接受VKA治疗的NVAF患者。通过自我填写问卷收集与VKA治疗相应的额外患者层面资源使用评估数据。将适用于2015年的单位成本乘以资源使用量并求和,以得出VKA治疗成本。

纳入363例患者;53%为男性。大多数患者接受氟茚二酮治疗(72%)。每位患者每月的INR检测次数为1.69次(95%CI,1.59 - 1.80)。从法国社会角度来看,每月患者成本为39.72欧元(36.23 - 43.21欧元)。直接医疗成本占总成本的76%,其中药品成本占7.4%(2.4欧元);直接非医疗成本和间接成本分别占10%和14%。

NVAF患者VKA治疗的相关成本不能仅通过药品成本来估算。当考虑与VKA治疗相关的直接和间接归因成本时,VKA治疗成本更为可观。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0368/6374971/a2553b963412/ZJMA_A_1564506_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0368/6374971/a2553b963412/ZJMA_A_1564506_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0368/6374971/a2553b963412/ZJMA_A_1564506_F0001_B.jpg

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本文引用的文献

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Overcoming global challenges in stroke prophylaxis in atrial fibrillation: The role of non-vitamin K antagonist oral anticoagulants.克服心房颤动卒中预防中的全球挑战:非维生素 K 拮抗剂口服抗凝剂的作用。
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Eur Heart J. 2016 Oct 7;37(38):2893-2962. doi: 10.1093/eurheartj/ehw210. Epub 2016 Aug 27.
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Impact of Switching From a Vitamin K Antagonist to Rivaroxaban on Satisfaction With Anticoagulation Therapy: The XANTUS-ACTS Substudy.从维生素K拮抗剂转换为利伐沙班对抗凝治疗满意度的影响:XANTUS-ACTS子研究
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Treatment Persistence and Discontinuation with Rivaroxaban, Dabigatran, and Warfarin for Stroke Prevention in Patients with Non-Valvular Atrial Fibrillation in the United States.在美国,利伐沙班、达比加群和华法林用于非瓣膜性心房颤动患者预防卒中的治疗持续性和停药情况。
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