Study On Pharmacoeconomics Of Three Different Proton Pump Inhibitors In The Treatment Of Non-variceal Upper Gastrointestinal Bleeding

Objective: The purpose of this study was to observe the effectiveness and safety of three different proton pump inhibitors in the treatment of non-variceal upper gastrointestinal bleeding under the background of real-world research,and to evaluate the difference between the three treatments by cost-effectiveness analysis,so as to provide reference for the safety,economy,effectiveness and reasonableness of the treatment schemes in our medical institutions.Methods: Random?controlled and prospective trial design was used in this study.From July 2012 to July 2014,patients diagnosed as non-variceal upper gastrointestinal bleeding in the gastroenterology departmentof a grade A class 3 general hospital were selected for study.The patients were randomly divided into three groups: group A(esomeprazole group),group B(omeprazole group)and group C(lansoprazole group).The effective time,hemostatic time,effective rate and safety of the three groups were observed and compared.The cost-effectiveness analysis in pharmacoeconomics was used to analyze the three groups,including cost / effect ratio,incremental cost / effect ratio and sensitivity analysis to uncertain factors.Results: The hemostatic time and effective time in esomeprazole group were significantly lower than those in omeprazole group and lansoprazole group,.The effective rate in esomeprazole group was 93.3%,which was higher than that in omeprazole group and lansoprazole group,but there was no statistical significance,the cost / effect ratio of omeprazole group was 11.1,which was 11.5 yuan lower than that of lansoprazole group.After reducing the price of drugs by 10%,the cost / effectiveness ratio of omeprazole group was 10.0,which was increased by one total effective rate compared with that of lansoprazole group with the lowest efficiency.The cost is reduced by 9.4 yuan,which is consistent with the previous research results.Monte Carlo simulation uncertainty analysis shows that drug price factors have no effect on the results of the study.Conclusion:The effect of three proton pump inhibitors on the treatment of non-variceal upper gastrointestinal bleeding was satisfactory.However,the effective time and the time of hemostasis of the esomeprazole group were shorter than that the other groups.From the analysis of the cost/ effectiveness ratio and the incremental cost/ effectiveness ratio,the cost of omeprazole group increases least for every additional treatment effect.The sensitivity analysis and the uncertainty factors of the treatment cost show that the price fluctuation of the drug does not affect the conclusion of the cost-effectiveness analysis.Comprehensive analysis of all factors: Omeprazole group has the most pharmacoeconomics advantage in the treatment of non-variceal upper gastrointestinal bleeding.