Peyron F, Flori A, Galliano-di Bernardo Bernardo S, Moreau J, Buès-Charbit M, Balansard G
Department of Pharmacy, C.H.U. Nord, Marseilles, France.
Pharm World Sci. 1997 Aug;19(4):202-7. doi: 10.1023/a:1008659911407.
This study was designed to evaluate drug use and drug costs of treatment of 1112 AIDS patients at the Infectious Diseases Unit at F. Houphouët Boigny Hospital in Marseilles, France, between January 1, 1990 and December 31, 1994. All drug expenditures directly or indirectly related to AIDS treatment were recorded for both inpatients and outpatients. There were 1952 hospital stays. For each stay baseline characteristics including age, sex risk factors, costs, and duration of hospitalization were noted. Patients were mainly young male drug addicts around thirty years of age. Reason for admission was also noted. The overall number of admissions per year has decreased since 1991 probably due to development of outpatient care. The number of stays per patient per year has decreased since 1993 because of the use of more appropriate therapeutic and prophylactic protocols. The number of drugs used was high increasing from 750 in 1990 to 868 in 1994. Cost of treatment doubled between 1990 and 1994 due to the introduction of many expensive new drugs. Closer analysis showed that the greatest increase in expenditure involved 'antibiotic/antiviral', 'psychiatry/neurology' and 'specialized therapy'. Although not frequently prescribed, costly drugs such as immunoglobulins, hematopoietic growth factors, and parenteral nutrition solutions accounted for a high proportion of total costs. Since AZT, ddI and ddC were used mainly for outpatient treatment, their cost was low in inpatients. Cytomegalovirus-related retinitis, tuberculosis, and multiple infections were cost-intensive complications. The increasing number of cytomegalovirus infections underlines the need for cost evaluation and surveillance of this complication. This study demonstrates that cost of treating AIDS patients is rising due to the use of more and costlier drugs. This finding underlines the need to evaluate and compare new therapeutic modalities in terms of cost effectiveness.
本研究旨在评估1990年1月1日至1994年12月31日期间，法国马赛F. 乌弗埃 - 博瓦尼医院传染病科对1112例艾滋病患者的药物使用情况和药物治疗费用。记录了住院患者和门诊患者与艾滋病治疗直接或间接相关的所有药物支出。共有1952次住院治疗。每次住院都记录了包括年龄、性别风险因素、费用和住院时间等基线特征。患者主要是30岁左右的年轻男性吸毒者。还记录了入院原因。自1991年以来，每年的入院总数有所下降，这可能是由于门诊治疗的发展。自1993年以来，由于采用了更合适的治疗和预防方案，每位患者每年的住院次数有所减少。使用的药物数量很多，从1990年的750种增加到1994年的868种。由于引入了许多昂贵的新药，1990年至1994年期间治疗费用翻了一番。进一步分析表明，支出增长最大的是“抗生素/抗病毒药物”、“精神病学/神经病学”和“专科治疗”。尽管使用频率不高，但免疫球蛋白、造血生长因子和肠外营养溶液等昂贵药物在总成本中占比很高。由于齐多夫定、去羟肌苷和双脱氧胞苷主要用于门诊治疗，其在住院患者中的费用较低。巨细胞病毒相关性视网膜炎、结核病和多重感染是成本高昂的并发症。巨细胞病毒感染数量的增加凸显了对这种并发症进行成本评估和监测的必要性。这项研究表明，由于使用了更多且更昂贵的药物，艾滋病患者的治疗成本正在上升。这一发现凸显了在成本效益方面评估和比较新治疗方式的必要性。
