[墨西哥2型糖尿病治疗的成本效益]
[Cost-effectiveness of treatment of type 2 diabetes mellitus in México].
作者信息
Pérez-Lozano Diana L, Camarillo-Nava Víctor Manuel, Juárez-Zepeda Tarsila Elizabeth, Andrade-Pineda José Elpidio, Pérez-López Danae, Reyes-Pacheco Jorge Armando, Lucho-Gutiérrez Zuley Margarita, Carmona-Aparicio Liliana
机构信息
Universidad Autónoma de México, Programa de Maestría y Doctorado en Ciencias Médicas y Odontológicas y de la Salud, Unidad de posgrado. Ciudad de México, México.
Instituto Mexicano del Seguro Social, Órgano de Operación Administrativa Desconcentrada Norte, Coordinación Auxiliar Médica de Investigación en Salud. Ciudad de México, México.
出版信息
Rev Med Inst Mex Seguro Soc. 2023 Mar 1;61(2):172-180.
BACKGROUND
Type 2 Diabetes Mellitus (DM2) is a public health and socioeconomic problem, generating direct medical costs for its treatment.
OBJECTIVE
To analyze the cost-effectiveness of monotherapy and bitherapy treatments in patients with DM2.
METHODS
Cost-effectiveness, observational, ambispective, cross-sectional and analytical analysis of files in a first level medical unit. The data in the cost matrix was executed with the Office Excel 2010 program; the most prescribed drug was identified and compared with monotherapy and bitherapy.
RESULTS
The annual direct medical costs of the total population were drug cost $118,561.70MN, hospitalization cost $243,756.00MN, consultation cost $327,414.00MN and clinical trial cost $2416.79MN, obtaining an annual total of $692,148.58MN. metformin was the most indicated in monotherapy (88.4%) and as standard therapy it has higher cost-effectiveness compared to glibenclamide. In bitherapy it was metformin/glibenclamide (35.7%) versus the therapeutics of metformin/NPH insulin, metformin/insulin glargine and metformin/dapagliflozin, which had a better cost-effective result, with an incremental cost effectiveness of -$1,128,428.50MN, -$34,365.00 MN, -$119,848.97MN respectively.
CONCLUSIONS
Metformin presented a better cost-effectiveness ratio in monotherapy, while in bitherapy it was the metformin/NPH insulin association.
背景
2型糖尿病（DM2）是一个公共卫生和社会经济问题，其治疗会产生直接医疗费用。
目的
分析DM2患者单药治疗和联合治疗的成本效益。
方法
对一级医疗单位的档案进行成本效益、观察性、双向性、横断面和分析性分析。成本矩阵中的数据使用Office Excel 2010程序执行；确定最常用药物并与单药治疗和联合治疗进行比较。
结果
总人口的年度直接医疗费用为药品费用118,561.70百万比索、住院费用243,756.00百万比索、会诊费用327,414.00百万比索和临床试验费用2416.79百万比索，年度总计692,148.58百万比索。二甲双胍在单药治疗中使用最多（88.4%），作为标准治疗，与格列本脲相比具有更高的成本效益。在联合治疗中，二甲双胍/格列本脲（35.7%）与二甲双胍/中效胰岛素、二甲双胍/甘精胰岛素和二甲双胍/达格列净的联合治疗相比，成本效益更好，增量成本效益分别为-1,128,428.50百万比索、-34,365.00百万比索、-119,848.97百万比索。
结论
二甲双胍在单药治疗中呈现出更好的成本效益比，而在联合治疗中则是二甲双胍/中效胰岛素联合。
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