抗高血压药物单药、联合及三联疗法的成本效益：一项回顾性队列研究。

Cost effectiveness of mono, dual, and triple therapy of antihypertensive drugs: a retrospective cohort study.

作者信息

Asim Zirwa

机构信息

Department of Pharmacy Practice, Shifa College of Pharmaceutical Sciences, Shifa Tameer e Millat University, Islamabad, Pakistan.

出版信息

Cost Eff Resour Alloc. 2025 Aug 14;23(1):43. doi: 10.1186/s12962-025-00614-y.

DOI:10.1186/s12962-025-00614-y

PMID:40813675

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12355811/

Abstract

BACKGROUND

Hypertension is a prevalent global health issue with far-reaching consequences. It impacts millions of individuals worldwide and poses significant risks to overall health. We aimed to explore and compare the cost-effectiveness and clinical efficacy of single, dual, and triple antihypertensive therapies in the management of blood pressure.

METHOD

This retrospective observational study evaluated the cost effectiveness of antihypertensive therapy from the inpatient records of hypertensive urgency patients from January 2022 to December 2022. Data was extracted from the medical records including crucial information such as MR number, name, gender, weight, dates of admission and discharge, co-morbidities, therapy type, prescribed drugs and doses, and blood pressure readings. Employing standard costing techniques, the study calculated direct medical costs associated with the patient's stay, medical care, nursing, and medication charges, considering the timeframe of August 2023. Data was analyzed using SPSS and Microsoft Excel. Mann Whitney and Kruskall Walis test was performed for statistical analysis.

RESULTS

Out of 120 patients, the majority were male 55% and between the age group 61-80 years i.e., 45%. The analysis revealed a statistically significant impact on systolic blood pressure across the different therapies. Monotherapy resulted in a higher median systolic BP (140.0 mmHg [IQR 6.27]) compared to dual therapy (136.7 mmHg [IQR 6.7]) and triple therapy (133.3 mmHg [IQR 10.0]), with a significant difference (p = 0.000). In terms of cost-effectiveness, triple therapy demonstrated the lowest average cost-effectiveness ratio (ACER) for systolic BP control PKR 1803, while dual therapy was the most cost-effective for diastolic BP management with PKR 2438.

CONCLUSION

The study concluded triple therapy as the most cost effective strategy for reducing systolic blood pressure, demonstrating its efficacy in blood pressure management. Conversely, dual therapy proved optimal for controlling diastolic blood pressure.

REGISTRATION

IRB # 0126 - 23 Dated: 24 July 2023.

摘要

背景

高血压是一个普遍存在的全球性健康问题，后果深远。它影响着全球数百万人，对整体健康构成重大风险。我们旨在探讨和比较单一、双重和三重抗高血压疗法在血压管理中的成本效益和临床疗效。

方法

这项回顾性观察研究从2022年1月至2022年12月高血压急症患者的住院记录中评估抗高血压治疗的成本效益。数据从病历中提取，包括重要信息，如病历号、姓名、性别、体重、入院和出院日期、合并症、治疗类型、处方药物和剂量以及血压读数。采用标准成本核算技术，该研究计算了与患者住院、医疗护理、护理和药物费用相关的直接医疗成本，考虑的时间范围为2023年8月。数据使用SPSS和Microsoft Excel进行分析。进行Mann Whitney和Kruskall Walis检验进行统计分析。

结果

在120名患者中，大多数为男性（55%），年龄在61-80岁之间（45%）。分析显示不同疗法对收缩压有统计学上的显著影响。与双重疗法（136.7 mmHg [四分位距6.7]）和三重疗法（133.3 mmHg [四分位距10.0]）相比，单一疗法导致更高的收缩压中位数（140.0 mmHg [四分位距6.27]），差异显著（p = 0.000）。在成本效益方面，三重疗法在收缩压控制方面显示出最低的平均成本效益比（ACER），为1803巴基斯坦卢比，而双重疗法在舒张压管理方面最具成本效益，为2438巴基斯坦卢比。