Pharmacoeconomic Evaluation Of Drugs In The Older Men With Osteoporosis

Objective:In the context of the rapid development of society, the widening gap between the limited health resources and medical service expectations, faced with the contradiction between the medicare funding restrictions and rising health care costs, and strive to minimize the cost and treatment optimization become common goal. Pharmacoeconomic on the basis of the evaluation of drug efficacy and safety, make a comprehensive judgment on the cost-effectiveness of the drug, become a powerful tool to provide information for policy-makers and health care payers and methods. Osteoporosis as a senile diseases in today’s aging society the heavy burden of disease, in osteoporosis drugs, find a safe, effective, Pharmacoeconomic al drug has important practical significance. Bushen Zhuanggu granul and Alendronate Sodium Tablets are able to treat senile osteoporosis in men, Alendronate Sodium Tablets significant effect has been fully confirmed. Bushen Zhuanggu granul as proprietary Chinese medicines, has its own characteristics and advantages, also has a role in the treatment of elderly men with osteoporosis. This study is based on a social perspective,use principles of Pharmacoeconomic,take a variety of Pharmacoeconomic evaluation methods to observe the Bushen Zhuanggu granul and Alendronate Sodium Tablets efficacy, safety, and adherence to the treatment of osteoporosis, evaluation of the two drugs on the improvement of the quality of life, and have Pharmacoeconomic analysis, designed to provide clinical reference for clinical users to provide data to support medical decision makers.Methods:First use of documentary research on the Pharmacoeconomic evaluation of the osteoporosis literature retrieval and sorting, master of the clinical symptoms of the disease burden of osteoporosis, medication, treatment effects, adverse reactions, drug Pharmacoeconomic research information, in order to found that the problems in the current study, design of research ideas. Collecting research data, Osteoporosis diagnostic criteria collected between June2011to November2011, in line with the99cases of elderly male patients as research subjects, use prospective randomized controlled clinical trial design method, Calcium Carbonate and Vitamin Tablets to set up basic for the control group, the subjects were randomly assigned to Bushen Zhuanggu granul groups, Alendronate Sodium Tablets groups and Calcium Carbonate and Vitamin Tablets groups, continuous single-blinded clinical observation6months. The treatment programs is:Bushen Zhuanggu granul group was given Bushen Zhuanggu granul, twice daily, each time a packet, a month later changed to, once a day, every time a pack, while adding Calcium Carbonate and Vitamin Tablets, daily one; Alendronate Sodium Tablets group was given Alendronate Sodium Tablets, one a week while adding Calcium Carbonate and Vitamin Tablets, daily one; Calcium Carbonate and Vitamin Tablets group given Calcium Carbonate and Vitamin Tablets,daily one.The effect observed indicators is BMD, PINP, β-crosslaps, N-MID, and to determine the clinical efficacy according to the percentage of the BMD changes calculated markedly effective and efficient. Utility index using the SF-36, rated the quality of life before and after the use of medication, calculated QALY. Blood pressure, liver and kidney function, biochemical parameters, adverse drug reactions, and endpoint events observed indicators for the evaluation of three sets of security and compliance. According to the research point of view, to establish costs, direct medical costs and indirect costs included in the cost range. Pharmacoeconomic assessment evaluation method using the following Pharmacoeconomic s to identify clinical therapy relatively better.1、decision tree model analysis:select subjects during treatment drug treatment efficiency, costs, adverse reactions and other indicators to build a decision tree model and expectations of cost and cost-effectiveness of each group of medication through the model calculated ratio.2、cost-effectiveness analysis:evaluation of the clinical efficacy of the treatment group, the clinical efficacy indicators to compare, if there are differences in calculation of the cost-effectiveness ratio, the smaller the value, the more excellent economy; if no difference in the minimum-cost analysis, only comp are the size of the cost, and low cost are preferred.3、cost-utility analysis: according to the dimension of the SF-36, the final score, converted by ICUR results with reference to the cost-effectiveness threshold criteria, Highly cost-effective (less than GDP per capita); Cost-effective (between one and three times GDP per capita); and Not cost-effective (more than three times GDP per capita).Results:1、The decision tree model analysis showed that Bushen Zhuanggu granul composition this effect value4727.734, Alendronate Sodium Tablets groups to4672.373, expect the effective value of the largest Alendronate Sodium Tablets.2、 Cost-effectiveness analysis showed that, After6months of treatment of subjects, BMD of Bushen Zhuanggu granul group and Alendronate Sodium Tablets groups ard significantly increased, PINP, β-Crosslaps and N-MID decreased. Bushen Zhuanggu granul group total effective rate of96.77%, the effective rate is65%; Alendronate Sodium Tablets group was100%and69%.There was no statistically significant difference in efficiency comparison. The Bushen Zhuanggu granul group and Alendronate Sodium Tablets group effect equivalent to the minimum cost method analysis results, total cost for two groups, respectively of4289.86yuan and4366.01 yuan, the Bushen Zhuanggu granul group slightly lower than Alendronate Sodium Tablets group, the difference is76.15yuan, Bushen Zhuanggu granul for the optimal solution.3、Cost-utility analysis results show that, between Bushen Zhuanggu granul group and Alendronate Sodium Tablets group, the difference of SF-36final score total was not statistically significant. QALY cost of each to get a complete, Bushen Zhuanggu granul are18,193.376yuan, Alendronate Sodium Tablets are18,583.682yuan, the data are less thantimes per capita GDP. From ICUR value judgment, Bushen Zhuanggu granul group relative to the Alendronate Sodium Tablets groups each get an additional QALY consumes36,850yuan, the data between1times and three times the per capita GDP between.Conclusion:1、the following conclusions can be drawn from the results of the evaluation of Pharmacoeconomic. The results of this study again confirmed the Alendronate Sodium Tablets is the drug of choice for the treatment of elderly men with osteoporosis, significant BMD enhancements, improve bone metabolism indicators to improve the patient’s quality of life, better compliance and security, at the same time the economy is also very significant. The results also confirmed the Bushen Zhuanggu granul as Chinese traditional medicines, treatment in older men worth promoting safe, effective and Pharmacoeconomic aspects with Alendronate Sodium Tablets very close osteoporosis. Efficacy of Bushen Zhuanggu granul and Alendronate Sodium Tablets no significant gap Pharmacoeconomic evaluation is basically the same, are safe and effective for the treatment of elderly male osteoporosis Pharmacoeconomic.2、Pharmacoeconomic evaluation of established research perspective is very important, it comes to the design of the entire study, the cost to determine the ideal from the point of view of society as a whole. Pharmacoeconomic evaluation under the point of view of society as a whole, regardless of the costs incurred by patients and their families, insurance companies, the health insurance sector, the government burden, the burden of subsidies or donor nature by any units or individuals, as long as the consumption of their own resources are under the point of view of the evaluation costs, achieve healthy and maximize the ultimate goal is based on the limited resources. Pharmacoeconomic evaluation process, direct non-medical costs, indirect costs, hidden costs are often incurred in obtaining more difficult to ignore, should consider the comprehensiveness of the evaluation of the cost of expanding the results of the evaluation scope.3、For reduce confounding bias Pharmacoeconomic studies, multiple drugs Pharmacoeconomic evaluation methods common application is a good way to prove that the same problem from a different direction, if you get the same answer, the research results are more convincing. But can also enhance the reliability of the results by expanding the sample size, the larger the sample can not be realized due to the limitations of the actual work, it is necessary to sample size estimates.4、Chinese medicine has a multi-component, multi-system, the combined effect of multiple targets, welcomed by the majority of patients, but the Pharmacoeconomic s of research and development of the traditional Chinese medicine is still relatively slow, some traditional Pharmacoeconomic evaluation model is not able to meet their requirements. Advanced technology model law, apply to the long-term efficacy study Markov model and decision tree model suitable for the short-term efficacy studies have their own advantages, but also have some limitations. Can be combined regimen characteristics to find mode adapt to evaluate the efficacy of Chinese medicine to promote traditional Chinese medicine Pharmacoeconomic evaluation methodology further forward.5、The SF-36as the utility of measuring tools, its universality, but with certain limitations evaluate the quality of life of the disease, may not fully reflect the real quality of life of the disease, but, as far as possible, to reflect changes in the quality of life. Using the SF-36for the characteristics of the object of study, some of the entries on the scale to be replaced, and strive to truly reflect the quality of life in patients.6、"Chinese Guidelines for Pharmacoeconomic Evaluations (2011)" was published in2011, the guide is based on the advantages of drawing on international guidelines, combined with Chinese Pharmacoeconomic s academic development of status quo. The current2011version of the guide, the content covers the general framework of the Pharmacoeconomic evaluation methods and norms, Pharmacoeconomic studies academia, government, and industry to provide a quality standard. Pharmacoeconomic s Research scholars should be based on the Guide clear Pharmacoeconomic evaluation perspective, the costs and benefits of a unified identification, measurement standards, evaluation methods, indicators Pharmacoeconomic play a more far-reaching role in the application areas.