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首页> 外文期刊>Pharmacoepidemiology and drug safety >A pharmacoeconomic comparison of misoprostol/diclofenac with diclofenac.
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A pharmacoeconomic comparison of misoprostol/diclofenac with diclofenac.

机译：米索前列醇/双氯芬酸与双氯芬酸的药效比较。

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OBJECTIVES: To estimate the economic impact of misoprostol/diclofenac in a fixed combination tablet compared with diclofenac. DESIGN: Cohort study with a prospectively constructed, population-based, record-linkage database containing details of exposure to all community dispensed NSAIDs and all admissions to hospital for upper gastrointestinal (GI) diagnoses. Costs associated with each study drug exposure were analysed using generalized linear models. SETTING: The population of Tayside, Scotland. SUBJECTS: Subjects aged 20 years and over who received misoprostol/diclofenac or any other NSAID between January 1989 and 31 December 1995. MAIN OUTCOME MEASURES: Total costs for the number of days of exposure to diclofenac and misoprostol/diclofenac, plus costs of concomitant ulcer healing drug therapy plus endoscopy procedures plus costs of admissions to hospital for upper GI diagnoses. RESULTS: The rate of hospitalization with gastrointestinal events was 30% higher among patients receiving diclofenac than that for patients receiving misoprostol/diclofenac. Among patients who received diclofenac and an ulcer-healing drug (UHD), the event rate was more than twice that for patients receiving misoprostol/diclofenac. In patients with a prior GI history, switching from diclofenac to misoprostol/diclofenac would reduce the costs of hospitalization. The resulting savings would more than offset the extra prescription costs. In patients without a prior GI history, the greatest potential saving would arise due to reduced use of UHDs and net savings would occur in subjects aged between 60 and 70 years of age or more. CONCLUSION: Use of misoprostol/diclofenac instead of diclofenac can produce cost savings due to reduced hospitalization rates and decreased use of UHDs in subjects with a prior history of GI disease and in older subjects without prior GI disease. These findings have implications for the management of patients who require treatment with NSAIDs.
机译：目的：评估与双氯芬酸相比固定组合片剂中米索前列醇/双氯芬酸的经济影响。设计：采用前瞻性，基于人口的记录链接数据库进行队列研究，该数据库包含所有社区分配的NSAID暴露以及所有上消化道（GI）诊断入院的详细信息。使用广义线性模型分析与每次研究药物暴露相关的费用。地点：苏格兰泰赛德的人口。受试者：1989年1月至1995年12月31日期间接受米索前列醇/双氯芬酸或任何其他NSAID的20岁及以上受试者。主要观察指标：双氯芬酸和米索前列醇/双氯芬酸接触天数的总费用，以及伴随溃疡的费用药物治疗，内窥镜检查程序以及上消化道诊断的住院费用。结果：接受双氯芬酸治疗的患者因胃肠道事件的住院率比接受米索前列醇/双氯芬酸的患者高30％。在接受双氯芬酸和溃疡愈合药物（UHD）的患者中，其发生率是接受米索前列醇/双氯芬酸的患者的两倍以上。在有胃肠道病史的患者中，从双氯芬酸改用米索前列醇/双氯芬酸会减少住院费用。由此产生的节省将远远抵消额外的处方费用。在没有胃肠道病史的患者中，由于减少了UHD的使用，将最大程度地节省费用，而在60至70岁或更高年龄的受试者中将实现净节省。结论：使用米索前列醇/双氯芬酸代替双氯芬酸可以节省成本，这是因为降低了住院率，降低了患有GI病史的受试者和没有GI病的老年受试者的UHD用量。这些发现对需要NSAID治疗的患者的治疗有影响。

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