比伐卢定用于经皮冠状动脉介入术的药物经济学研究综述
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摘要
目的:综合评价比伐卢定用于冠心病患者经皮冠状动脉介入治疗术(PCI)围手术期抗凝治疗的国际药物经济学研究,探讨比伐卢定的临床抗凝治疗效果、成本及不良反应。方法:从Pubmed数据库检索有关比伐卢定用于PCI抗凝治疗的药物经济学分析的英文文献,对研究内容及结果进行汇总评论,综述比伐卢定用于PCI围手术期抗凝治疗的药物经济学评估结果。结果:纳入综述研究的12篇药物经济学评估文献显示,于传统的肝素联合抗凝治疗方案相比,比伐卢定单药成本较高,但能显著降低MI、UR、出血、再缺血等并发症风险,延长患者预后生存年限,降低医疗成本,具有成本效益。结论:比伐卢定较传统的肝素联合方案用于PCI围手术期抗凝治疗在疗效和成本上具有一定优势,其国外临床经验药物经济学评估具有成本效益。
Objective:Literature review pharmacoeconomic analysis on patients undergoing percutaneous coronary intervention(PCI) been treated with bivalirudin, to explore the efficacy, safety and cost-effectiveness on the addition of bivalirudin.Methods:Search the English literature of pharmacoeconomic analysis of bivalirudin on Pub Med database,summarize and evaluate the researchcontent and result, evaluate the evaluation result of pharmacoeconomics on using bivalirudin on PCI perioperative anticoagulant thera-py.Result:According to 12 evaluation literature of pharmacoeconomics, compared with traditional heparin anticoagulation therapy,bivalirudin had higher cost,which could significantly decrease the risks of MI,UR,bleedingrate and recurrent ischemic,prolongthe QLAYs of patients and decrease the medical cost,which had cost-effectiveness.Conclusion:Compared with the traditional hep-arin anticoagulation therapy,bivalirudin had certain advantage on the treatment and cost for PCI perioperative anticoagulant therapy.The evaluation on foreign clinical pharmacoeconomics had cost-effectiveness.
Objective:Literature review pharmacoeconomic analysis on patients undergoing percutaneous coronary intervention(PCI) been treated with bivalirudin, to explore the efficacy, safety and cost-effectiveness on the addition of bivalirudin.Methods:Search the English literature of pharmacoeconomic analysis of bivalirudin on Pub Med database,summarize and evaluate the researchcontent and result, evaluate the evaluation result of pharmacoeconomics on using bivalirudin on PCI perioperative anticoagulant thera-py.Result:According to 12 evaluation literature of pharmacoeconomics, compared with traditional heparin anticoagulation therapy,bivalirudin had higher cost,which could significantly decrease the risks of MI,UR,bleedingrate and recurrent ischemic,prolongthe QLAYs of patients and decrease the medical cost,which had cost-effectiveness.Conclusion:Compared with the traditional hep-arin anticoagulation therapy,bivalirudin had certain advantage on the treatment and cost for PCI perioperative anticoagulant therapy.The evaluation on foreign clinical pharmacoeconomics had cost-effectiveness.
引文
[1]SUMMERS K M,HOLDFOLD D A,CROUCH M A,et al.Cost-effectiveness analysis of antithrombotic therapy in non-urgent percutaneous coronary intervention[J].Pharmacother-apy,2006,26(5):609-618.
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[3]AMIN A P,MARSO S P,RAO S V,et al.Cost-effective-ness of targeting patients undergoing percutaneous coronaryintervention for therapy with bivalirudin versus heparinmonotherapy according to predicted risk of bleeding[J].Circcardiovasc qual outcomes,2010,3(4):358-365.
[4]WISE G R,SCHWARTZ B P,DITTOE N,et al.Compara-tive effectiveness analysis of anticoagulant strategies in alarge observational database of percutaneous coronary inter-ventions[J].Journal of interventional cardiology,2012,25(3):278-288.
[5]PINTO D S,OGBONNAYA A,SHERMAN S A,et al.Bi-valirudin therapy is associated with improved clinical andeconomic outcomes in ST-elevation myocardial infarctionpatients undergoing percutaneous coronary intervention:re-sults from an observational database[J].Circ cardiovascqual outcomes,2012,5(1):52-61.
[6]BORG S,PERSSON U,ALLIKMETS K,et al.Comparativecost-effectiveness of anticoagulation with bivalirudin or hep-arin with and without a glycoprotein IIb/IIIa-receptor inhibi-tor in patients undergoing percutaneous coronary interven-tion in Sweden:a decision-analytic model[J].Clinical thera-peutics,2006,28(11):1947-1959.
[8]SCHWENKGLENKS M,BRAZIER J E,SZUCS T D,et al.Cost-effectiveness of bivalirudin versus heparin plus glyco-protein IIb/IIIa inhibitor in the treatment of non-ST-seg-ment elevation acute coronary syndromes[J].Value health2011,14(1):24-33.
[9]PUYMIRAT E,COHENA S,V DRENNE G,et al.Cost analysis of bivalirudin versus reference anticoagulants with-out GP IIb/IIIa inhibitors in patients undergoing percutane-ous coronary intervention for acute coronary syndrome inroutine clinical practice.Pompidou registry[J].Annales decardiologie et d’angéiologie,2013,62(2):89-94.
[10]HAMON M,BONELLO L,MARSO S,et al.Comparison ofbivalirudin versus heparin(s)during percutaneous coronaryinterventions in patients receiving prasugrel:a propensi-ty-matched study[J].Clin cardiol,2014,37(1):14-20.
[11]MATTHIAS S,BRAZIER J E,SZUCS T D,et al.Cost-ef-fectiveness of bivalirudin versus heparin plus glycoproteinIIb/IIIa inhibitor in the treatment of non-ST-segment ele-vation acute coronary syndromes[J].Value health,2011,14(1):24-33.
[12]SCHWENKGLENKS M,TOWARD T,PLENT S,et al.Cost-effectiveness of bivalirudin versus heparin plus gly-coprotein IIb/IIIa inhibitor in the treatment of acuteST-segment elevation myocardial infarction[J].Heart,2012,98(7):544551.
[13]MAXWELL C B,HOLDFORD D A,CROUCH M A,et al.Cost-effectiveness analysis of anticoagulation strategies innon-ST-elevation acute coronary syndromes[J].Ann phar-macother,2009,43(4):586-595.
[14]KRISTIN W,SEYBERT A L,SAUL M I,et al.Compari-son of patient outcomes with bivalirudin versus unfraction-ated heparin in percutaneous coronary intervention[J].Pharmacotherapy,2007,27(5):647-656.
[15]KESSLER D P,KROCH E,HLATKY M A,et al.The ef-fect of bivalirudin on costs and outcomes of treatment ofST-segment elevation myocardial infarction[J].Am heart J,2011,162(3):494-500.
[16]COHEN D J,LINCOFF A M,LAVELLE T A,et al.Eco-nomic evaluation of bivalirudin with provisional glycopro-tein IIb/IIIa inhibition versus heparin with routine glyco-protein IIb/IIIa inhibition for percutaneous coronary inter-vention results from the REPLACE-2 trial[J].Journal ofthe American college of cardiology,2004,44(9):1792-1800
[17]RAJAGOPAL V,LINCOFF A M,COHEN D J,et al.Out-comes of patients with acute coronary syndromes who aretreated with bivalirudin during percutaneous coronary inter-vention:an analysis from the randomized evaluation inPCI linking angiomax to reduced clinical events(RE-PLACE-2)trial[J].American heart journal,2006,152(1):149-154.
[2]ANTHONY C.A practical cost analysis of bivalirudin[J].Pharmacotherapy,2002,22(6P2):119-127.
[3]AMIN A P,MARSO S P,RAO S V,et al.Cost-effective-ness of targeting patients undergoing percutaneous coronaryintervention for therapy with bivalirudin versus heparinmonotherapy according to predicted risk of bleeding[J].Circcardiovasc qual outcomes,2010,3(4):358-365.
[4]WISE G R,SCHWARTZ B P,DITTOE N,et al.Compara-tive effectiveness analysis of anticoagulant strategies in alarge observational database of percutaneous coronary inter-ventions[J].Journal of interventional cardiology,2012,25(3):278-288.
[5]PINTO D S,OGBONNAYA A,SHERMAN S A,et al.Bi-valirudin therapy is associated with improved clinical andeconomic outcomes in ST-elevation myocardial infarctionpatients undergoing percutaneous coronary intervention:re-sults from an observational database[J].Circ cardiovascqual outcomes,2012,5(1):52-61.
[6]BORG S,PERSSON U,ALLIKMETS K,et al.Comparativecost-effectiveness of anticoagulation with bivalirudin or hep-arin with and without a glycoprotein IIb/IIIa-receptor inhibi-tor in patients undergoing percutaneous coronary interven-tion in Sweden:a decision-analytic model[J].Clinical thera-peutics,2006,28(11):1947-1959.
[8]SCHWENKGLENKS M,BRAZIER J E,SZUCS T D,et al.Cost-effectiveness of bivalirudin versus heparin plus glyco-protein IIb/IIIa inhibitor in the treatment of non-ST-seg-ment elevation acute coronary syndromes[J].Value health2011,14(1):24-33.
[9]PUYMIRAT E,COHENA S,V DRENNE G,et al.Cost analysis of bivalirudin versus reference anticoagulants with-out GP IIb/IIIa inhibitors in patients undergoing percutane-ous coronary intervention for acute coronary syndrome inroutine clinical practice.Pompidou registry[J].Annales decardiologie et d’angéiologie,2013,62(2):89-94.
[10]HAMON M,BONELLO L,MARSO S,et al.Comparison ofbivalirudin versus heparin(s)during percutaneous coronaryinterventions in patients receiving prasugrel:a propensi-ty-matched study[J].Clin cardiol,2014,37(1):14-20.
[11]MATTHIAS S,BRAZIER J E,SZUCS T D,et al.Cost-ef-fectiveness of bivalirudin versus heparin plus glycoproteinIIb/IIIa inhibitor in the treatment of non-ST-segment ele-vation acute coronary syndromes[J].Value health,2011,14(1):24-33.
[12]SCHWENKGLENKS M,TOWARD T,PLENT S,et al.Cost-effectiveness of bivalirudin versus heparin plus gly-coprotein IIb/IIIa inhibitor in the treatment of acuteST-segment elevation myocardial infarction[J].Heart,2012,98(7):544551.
[13]MAXWELL C B,HOLDFORD D A,CROUCH M A,et al.Cost-effectiveness analysis of anticoagulation strategies innon-ST-elevation acute coronary syndromes[J].Ann phar-macother,2009,43(4):586-595.
[14]KRISTIN W,SEYBERT A L,SAUL M I,et al.Compari-son of patient outcomes with bivalirudin versus unfraction-ated heparin in percutaneous coronary intervention[J].Pharmacotherapy,2007,27(5):647-656.
[15]KESSLER D P,KROCH E,HLATKY M A,et al.The ef-fect of bivalirudin on costs and outcomes of treatment ofST-segment elevation myocardial infarction[J].Am heart J,2011,162(3):494-500.
[16]COHEN D J,LINCOFF A M,LAVELLE T A,et al.Eco-nomic evaluation of bivalirudin with provisional glycopro-tein IIb/IIIa inhibition versus heparin with routine glyco-protein IIb/IIIa inhibition for percutaneous coronary inter-vention results from the REPLACE-2 trial[J].Journal ofthe American college of cardiology,2004,44(9):1792-1800
[17]RAJAGOPAL V,LINCOFF A M,COHEN D J,et al.Out-comes of patients with acute coronary syndromes who aretreated with bivalirudin during percutaneous coronary inter-vention:an analysis from the randomized evaluation inPCI linking angiomax to reduced clinical events(RE-PLACE-2)trial[J].American heart journal,2006,152(1):149-154.