药物经济学在慢性阻塞性肺疾病治疗中的应用 -药学专业

摘要

慢性阻塞性肺疾病（COPD）是全球范围内常见的慢性呼吸系统疾病，给患者和社会带来了沉重的经济负担。为优化医疗资源配置并提高治疗效益，本研究旨在探讨药物经济学在COPD治疗中的应用价值。通过系统性文献回顾与me ta分析，结合国内多家三甲医院2018 - 2022年期间收治的567例COPD患者的临床数据，采用成本-效果分析、成本-效用分析等方法，对比不同治疗方案的成本效益。结果显示，在稳定期COPD患者中，长效支气管扩张剂联合吸入糖皮质激素方案相较于单一支气管扩张剂方案，在改善患者生活质量方面具有显著优势，且增量成本效果比低于当地人均GDP，具备良好的经济学价值；对于急性加重期患者，非侵入性机械通气联合药物治疗较传统有创通气方式能够有效降低住院天数和再入院率，节省医疗资源。本研究创新性地将药物经济学原理应用于COPD全程管理，为制定科学合理的医保政策及临床路径提供了理论依据，有助于推动精准医疗发展，实现医疗资源的高效配置。

关键词：慢性阻塞性肺疾病；药物经济学；成本-效果分析

Abstract

Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease worldwide, imposing a substantial economic burden on patients and society. To optimize the allocation of medical resources and improve treatment efficacy, this study aims to investigate the application value of pharmacoeconomics in COPD treatment. Through systematic literature review and me ta-analysis, combined with clinical data from 567 COPD patients treated in multiple tertiary hospitals in China during the period of 2018-2022, cost-effectiveness analysis and cost-utility analysis methods were employed to compare the cost-effectiveness of different treatment regimens. The results showed that for stable COPD patients, the combination of long-acting bronchodilators and inhaled corticosteroids demonstrated significant advantages in improving quality of life compared to single bronchodilator therapy, with an incremental cost-effectiveness ratio lower than the local per capita GDP, indicating favorable economic value. For patients experiencing acute exacerbations, non-invasive mechanical ventilation combined with pharmacotherapy effectively reduced hospital stays and readmission rates compared to traditional invasive ventilation, thereby conserving medical resources. This study innovatively applies the principles of pharmacoeconomics to the comprehensive management of COPD, providing theoretical evidence for formulating scientifically sound health insurance policies and clinical pathways, which contributes to the development of precision medicine and the efficient allocation of medical resources.

Keywords：Chronic Obstructive Pulmonary Disease；Pharmacoeconomics；Cost-Effectiveness Analysis

摘要 I

Abstract II

引言 1

第一章慢性阻塞性肺疾病的经济负担 2

1.1 疾病直接成本分析 2

1.2 间接成本评估 2

1.3 社会经济影响 3

第二章药物治疗的成本效益分析 5

2.1 不同药物方案的成本对比 5

2.2 治疗效果的量化评估 5

2.3 成本效益模型构建 6