Observation of Curative Effect and Pharmacoeconomic Evaluation of Initially Treated Tuberculosis Patients in Ningbo

OBJECTIVE To retrospectively analyze the efficacy, adverse reactions and drug resistance of a city-level designated hospital in the treatment of initially treated tuberculosis patients in Ningbo, and to evaluate the pharmacoeconomics, so as to provide a scientific basis for the clinical formulation of safe, effective and economic treatment programs. METHODS A total of 2 455 patients with pulmonary tuberculosis treated in this designated hospital from January 2017 to December 2018 were collected. According to different drug regimens, they were divided into fixed dose compound preparation group(2 tablets of Ethambutol Hydrochloride, Pyrazinamide, Rifampicin and Isoniazid Tablets/4 tablets of Rifampicin and Isoniazid Tablets), quadruple bulk drug group(2HRZE/4HR), fixed dose compound preparation and bulk drug mixed drug group 1(2 tablets of Ethambutol Hydrochloride, Pyrazinamide, Rifampicin and Isoniazid Tablets/4HR) and group 2(2HRZE/4 tablets of Rifampicin and Isoniazid Tablets). The sputum smear negative conversion rate, sputum culture negative conversion rate and focus of patients with pulmonary tuberculosis treated by four drug regimens were compared and analyzed. Absorption rate, cavity closure rate, drug resistance rate, incidence of adverse reactions and cost-effectiveness analysis, single-factor sensitivity analysis with cost as parameter and Monte Carlo iteration simulation were used to evaluate the probabilistic safety of the combined drug regimen, and the cost-effectiveness acceptable curve was drawn. RESULTS Fixed-dose compound preparation group, quadruple bulk drug group, mixed drug group 1 and mixed drug group 2 had similar therapeutic effects in sputum smear negative conversion rate, sputum culture negative conversion rate, focus absorption rate and cavity closure rate, and the drug resistance rate and adverse reactions rate of quadruple bulk drug group were the highest. Cost-effectiveness acceptable curve showed that the willingness-to-pay value and cost-effectiveness probability of fixed dose compound preparation group showed a decreasing curve compared with quadruple bulk charge group. When the minimum willingness-to-pay value was 8 000 Yuan, the maximum cost-effectiveness could be achieved. CONCLUSION The cost-effectiveness ratio of fixed dose compound preparation group is the smallest. Compared with other three groups, this scheme can obtain the maximum cost-effectiveness probability at a lower amount of willingness-to-pay. It is a relatively economic and effective optimal scheme.