1 The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China.
2 Beijing Mental Health Care Institute, Beijing, China.
Int J Soc Psychiatry. 2019 Feb;65(1):28-37. doi: 10.1177/0020764018815200. Epub 2018 Nov 30.
Beijing municipal government launched a Free Drug Program (FDP) in 2013 to reduce the financial burden of schizophrenia patients.
To assess the cost-effectiveness of a FDP designed for schizophrenia patients in Beijing, China.
In all, 2007 schizophrenia patients enrolled in an FDP (FDP group) and 2001 schizophrenia patients who were not enrolled (non-FDP group) were randomly selected for a cross-sectional survey in August 2015. The study sought to develop a cost-effectiveness model to assess the FDP from the societal perspective in Beijing, China. Scenario analyses explored the potential strategies to further improve the cost-effectiveness of the FDP.
The FDP group was associated with lower socioeconomic status and more advanced disease than the non-FDP group (unemployment rate: 48.8% vs 37.3%, p < .001; disability rate: 91.2% vs 64.1%, p < .001; overall comorbidity rate: 34.9% vs 28.8%, p < .001). The two groups exhibited similar disease severity and quality of life. However, the FDP group was associated with significantly lower direct medical costs (coefficient -.342, p = .003) and indirect costs (coefficient -.473, p < .001) than the non-FDP group. The base case incremental cost-effectiveness ratio (ICER) per gained quality-adjusted life year (QALY) for the FDP group relative to the non-FDP group was 1.480 times of 2015 China's gross domestic product per capita. Home drug delivery and long-lasting injection treatment could reduce the ICER for the FDP group relative to the non-FDP group by 57.8% and 29.8%, respectively.
The FDP was attractive to schizophrenia patients with lower socioeconomic status and more advanced disease. The cost-effectiveness of the FDP was acceptable and could be further improved by home drug delivery and long-lasting injection treatment.
北京市政府于 2013 年启动了免费药物计划（FDP），以减轻精神分裂症患者的经济负担。
评估专为中国北京精神分裂症患者设计的 FDP 的成本效益。
2015 年 8 月，我们随机选择了 2007 名参加 FDP 的精神分裂症患者（FDP 组）和 2001 名未参加 FDP 的精神分裂症患者（非 FDP 组）进行横断面调查。该研究旨在从中国北京的社会角度建立一个 FDP 的成本效益模型。情景分析探讨了进一步提高 FDP 成本效益的潜在策略。
与非 FDP 组相比，FDP 组的社会经济地位较低，疾病程度较严重（失业率：48.8%比 37.3%，p<0.001；残疾率：91.2%比 64.1%，p<0.001；总合并症发生率：34.9%比 28.8%，p<0.001）。两组的疾病严重程度和生活质量相似。然而，FDP 组的直接医疗费用（系数-.342，p=0.003）和间接费用（系数-.473，p<0.001）明显低于非 FDP 组。FDP 组相对于非 FDP 组每获得一个质量调整生命年（QALY）的增量成本效益比（ICER）为 2015 年中国人均国内生产总值的 1.480 倍。家庭药物配送和长效注射治疗可使 FDP 组相对于非 FDP 组的 ICER 分别降低 57.8%和 29.8%。
FDP 对社会经济地位较低、疾病程度较严重的精神分裂症患者具有吸引力。FDP 的成本效益是可以接受的，通过家庭药物配送和长效注射治疗可以进一步提高其成本效益。
