Cost-effective Selection of H_2 Receptor Antagonists for Upper Gastrointestinal Hemorrhage in Japanese Hospital Setting
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概要
- 論文の詳細を見る
The aim of this study was to identify the most favorable H_2RA (H_2 receptor antagonist) for the treatment of upper gastrointestinal hemorrhage (non-phlebeurysm). A decision tree was constructed to evaluate cost-effectiveness among an existing treatment (control), roxatidine, famotidine and ranitidine from the viewpoints of the payer and the medical facility. Clinical parameters used as transition probabilities were obtained from the results of the domestic RCT (Randomized Controlled Trial) of each drug. The cost items consisted of the direct medical cost, capital cost, and medical staff (doctors and nurses) personnel costs. The time horizon was set at 12.3 days on average and there was therefore no discount. Of the three drugs, at approximately 140,000 yen less than the control, ranitidine was estimated to be most cost-saving for the payer. In percentage terms, ranitidine had the highest earnings rate among the H_2RAs of 46.0% and roxatidine had the highest earnings in money terms among the H_2RAs of approximately 120,000 yen. A one-way sensitivity analysis used for investigating extra periods of hospitalization showed that this had no impact on the base case. A two-way analysis showed that ranitidine had the highest efficiency of about 55% for the cases analyzed. When a threshold analysis was conducted, it was found that, while there would be no change in the hemostatic rate in substitutive plans, the hemostatic rate of 0.60 for famotidine (ceiling total cost : 375,801 yen) and that of 0.61 for ranitidine (ceiling total cost : 406,271 yen) were the thresholds affecting the results of analysis. It is therefore likely that selecting ranitidine first in preference to roxatidine or famotidine would be more cost-effective.
- 日本医療薬学会の論文
- 2005-04-10
著者
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Uetsuka Yoshio
Department of Cardiology, Tokyo Women's Medical University
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Fukuda Sachiko
Department of Cardiology, Aichi Medical University
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Fukuda Sachiko
Department Of Cardiology Aichi Medical University
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Fukuda Sachiko
Department Of Pharmacy St. Luke's International Hospital
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Uetsuka Yoshio
Department Of Cardiology Tokyo Women's Medical College
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Inoue Tadao
Department of Pharmacy, St. Luke's International Hospital
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Inoue Tadao
Department Of Biotechnology Fukuyama University
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FUJITA Yoshiyuki
Department of Medicine, St. Luke's International Hospital
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Fujita Yoshiyuki
Department Of Gastroenterology St. Luke's International Hospital
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Inoue Tadao
Department Of Pharmacy St. Luke's International Hospital:department Of Health Services And Hosp
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Uetsuka Yoshio
Department Of Cardiology
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Fujita Yoshiyuki
Department Of Gastroenterology St Luke's International Hospital
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