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在哥伦比亚背景下,静脉溃疡治疗中腔内和腔周重组人表皮生长因子与水胶体疗法的成本效益分析。

Cost-effectiveness analysis of intralesional and perilesional recombinant human epidermal growth factor vs hydrocolloid therapy in venous ulcer treatment in the Colombian context.

机构信息

Health Services, Ambulatory Surgery Center, Hospital Occidente de Kennedy, Vascular Laboratory SURA, Bogotá, Colombia.

Vascular Surgeon, Colombian Association for Vascular Surgery, Bogotá, CO.

出版信息

J Vasc Surg Venous Lymphat Disord. 2024 Mar;12(2):101745. doi: 10.1016/j.jvsv.2023.101745. Epub 2023 Dec 23.

Abstract

OBJECTIVE

To perform a comparative analysis of health care expenses and outcomes in response to the question: What is the cost-effectiveness of intralesional and perilesional recombinant human epidermal growth factor (rhEGF) compared with hydrocolloid therapy in patients diagnosed with chronic venous insufficiency without infection in Colombia?

METHODS

A Markov model was used to determine cost effectiveness over a 5-year period, considering the perspective of the health system in Colombia. The study included patients aged >18 years diagnosed with chronic venous insufficiency and used clinical studies to calculate the probabilities of epithelialization, infection, recurrence, and mortality.

RESULTS

RhEGF is more expensive per unit than hydrocolloids, but it is proven to be effective at healing ulcers in 8 to 12 weeks, even in complex cases. Hydrocolloids, in contrast, typically require 29.5 weeks on average, and ≤46 weeks for complex cases. Despite the cost, rhEGF is more cost effective because it achieves results comparable with hydrocolloid therapy at a lower cost per additional quality-adjusted life-year.

CONCLUSIONS

Based on cost-effectiveness analysis, rhEGF is a superior alternative to hydrocolloids for treating venous ulcers in Colombia. Not only is it more affordable, but it also enhances patients' quality of life and streamlines the health care system's resource use.

摘要

目的

通过比较分析医疗费用和结果,回答以下问题:在哥伦比亚,针对无感染的慢性静脉功能不全患者,与水胶体疗法相比,皮损内和皮损周围使用重组人表皮生长因子(rhEGF)的成本效益如何?

方法

采用马尔可夫模型,从哥伦比亚卫生系统的角度出发,确定了 5 年内的成本效益。该研究纳入了年龄>18 岁、诊断为慢性静脉功能不全的患者,并使用临床研究来计算上皮化、感染、复发和死亡率的概率。

结果

rhEGF 每单位的价格高于水胶体,但它能在 8 至 12 周内有效治愈溃疡,即使是复杂病例。相比之下,水胶体通常需要平均 29.5 周,复杂病例则需要≤46 周。尽管成本较高,但 rhEGF 更具成本效益,因为它以更低的每额外质量调整生命年成本实现了与水胶体治疗相当的效果。

结论

基于成本效益分析,rhEGF 是治疗哥伦比亚静脉溃疡的水胶体的更好选择。它不仅更经济实惠,还能提高患者的生活质量并优化卫生保健系统的资源利用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9740/11523390/4a9547eef5c8/gr1.jpg

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