Hillman A L
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia 19104-6218.
Scand J Gastroenterol Suppl. 1994;201:98-102. doi: 10.3109/00365529409105374.
The economic evaluation of new medicines is increasingly important for pricing, registration and selection for use. A decision-analytic strategy was performed to assess the economic impact of antacids alone (phase I therapy), and in combination with either omeprazole, 20 mg once daily, or ranitidine, 150 mg twice daily, for patients with persistent, symptomatic gastro-oesophageal reflux disease of grade II or more (Savary-Miller classification). Data were obtained from published literature, an expert panel of gastroenterologists and actual payments by a private insurer in the USA. Over the 7-month period of the analysis, omeprazole reduced both symptoms and overall costs when compared with ranitidine or antacids. Consequently, the cost per symptom-free month was 43% lower with omeprazole than with ranitidine. Thus, omeprazole should be considered as the initial therapeutic approach for patients in whom phase I therapy fails.
新药的经济评估对于定价、注册和选用愈发重要。我们采用了一种决策分析策略，以评估单独使用抗酸剂（I 期治疗）以及联合每日一次服用 20 毫克奥美拉唑或每日两次服用 150 毫克雷尼替丁，对患有 II 级或更高级别持续性症状性胃食管反流病（Savary-Miller 分类）患者的经济影响。数据来自已发表的文献、胃肠病专家组成的专家小组以及美国一家私人保险公司的实际支付情况。在分析的 7 个月期间，与雷尼替丁或抗酸剂相比，奥美拉唑既能减轻症状又能降低总体成本。因此，使用奥美拉唑时每个无症状月的成本比使用雷尼替丁时低 43%。所以，对于 I 期治疗失败的患者，应考虑将奥美拉唑作为初始治疗方法。
