van Hout B A, Birnie E, Redekop W K, Lorijn R H, Bossuyt P M, Rutten F F
Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands.
Prog Clin Biol Res. 1994;388:435-43.
The cost-effectiveness of prescribing HA-1A for sepsis patients was analyzed by comparing effectiveness and direct medical costs. Effectiveness was estimated on the basis of published data from a randomized clinical trial. Costs were determined by combining data from the same trial with expectations about hospital days. Average costs per life year gained were estimated at 25,000 Dutch guilders (1 Dutch guilder is approximately 53 US cents). Sensitivity analyses were applied and showed that the effectiveness and cost-effectiveness of treating patients with HA-1A depend a great deal on the expected duration of survival after successful treatment. If the objective is to maximize the cost-effectiveness of treatment, this means that the prognosis of the patient should be considered when deciding about the appropriateness of treatment with HA-1A. As one would expect, another way to increase cost-effectiveness would be to increase the proportion of gram-negative sepsis patients amongst those receiving treatment.
通过比较疗效和直接医疗成本，分析了为脓毒症患者开具HA-1A的成本效益。疗效是根据一项随机临床试验的已发表数据估算得出的。成本是通过将同一试验的数据与对住院天数的预期相结合来确定的。每获得一个生命年的平均成本估计为25000荷兰盾（1荷兰盾约合53美分）。进行了敏感性分析，结果表明，用HA-1A治疗患者的疗效和成本效益在很大程度上取决于成功治疗后的预期存活时间。如果目标是使治疗的成本效益最大化，这意味着在决定HA-1A治疗的适用性时应考虑患者的预后。正如人们所预期的，提高成本效益的另一种方法是增加接受治疗的革兰氏阴性脓毒症患者的比例。
