Comparison Of Cost Effectiveness Of RhG-CSF And RhGM-CSF In The Treatment Of Severe Bone Marrow Suppression After Chemotherapy And The Investigation On The Cognition Of Physicians And Pharmacists

Objective: To retrospective evaluat the differences of cost-effectiveness and safety of severe bone marrow suppression after chemotherapy treatment in recombinant human granulocyte-macrophage colony-stimulating factor and recombinant human granulocyte colony-stimulating factor,and investigate the cognition situation of the doctor and pharmacist,as the basis to provide reference for clinical rational use of drugs.Methods: Extraction the during a hospital general surgery,thoracic surgery received chemotherapy and resulted in 68 cases with IV degree myelosuppression(white blood cell count<1.0×109/L or polymorphonuclear cell count < 0.5×109/L)were retrospectively analyzed in January 2014 to July 2015.The patients were divided into two groups,the rhGM-CSF group: 35 cases,subcutaneous injection;rh G-CSF group: 33 cases,subcutaneous injection.Compare the efficacy,adverse reactions and cost of treatment in the two groups after treatment.taking cost effectiveness ratio(C/E),incremental cost effectiveness ratio(ΔC/ΔE),index of the two schemes of pharmacoeconomic cost-effectiveness evaluation analysis respectively.Respectively,for physicians and pharmacists design questionnaire,random sample of 60 physicians and 32 pharmacists completed the questionnaire.Analysis of the physician,pharmacist on rhG-CSF and rhGM-CSF cognition and use of the situation.All the data using SPSS18.0 software processing,of classification data with constituent ratio,rate of statistical description.The quantitative data using x ±S for statistical description;Between groups comparison according to the type of data using independent samples t test or chi square test,P < 0.05 for differences have statistical significance.Results: rhGM-CSF and rhG-CSF group the cure rate was 74.28% respectively,93.49%,P=0.03,two groups have significant differences;Granulocyte to normal level time rhGM-CSF was 4.96±170 days,rhG CSF was 3.40±0.92 days(P < 0.01),RhG-CSF group was significantly shorter than that in the group of rh GM-CSF;On platelet effect of rhGM-CSF group 45.34±8.96,rhG-CSF group 14.38±3.58,P < 0.01,the difference was significant;Had no effect on hemoglobin.Therefore,comprehensive evaluation of the therapeutic effect of the two groups have significant difference.The incidence of adverse reactions of both groups were lower and rhGM-CSF group was 5.71%,rhG-CSF group was 3.03% and Fisher ’s exa CT results P=1.00,there was no significant difference.The cost of treatment,the two groups were 934.92 yuan,respectively,705.44yuan;Cost-effectiveness analysis(C/E)display rhGM-CSF group of 10.56,rhG-CSF group 7.05,at the lowest cost(rhG-CSF group)as a reference,△C>0,△E<0,the ICER for-40.19 and display of rhG-CSF group advantage;Sensitivity analysis results show that the results of the aforementioned cost-effect analysis of true and reliable.Issued 92 copies of questionnaires and recovered 92 samples and 60 copies of which physicians,pharmacists 32,recovery rate was 100.00%.Results show that the hospital surveyed physicians and pharmacists to rise granulocyte drugs awareness is acceptable,pharmacists relatively higher(P=0.04);In addition,two groups of two kinds of drugs in different dosage of rise the effect of granulocyte attention degree is not enough,and the curative effect of the two,security and understanding of cost-effectiveness was low and the difference was not significant.Conclusion: Comprehensive evaluat the effectiveness,safety and economy of two kinds of drugs ingranulocyte in increased granulocyte from the cost-effectiveness and adverse reactions.rhG-CSF group scheme in the treatment of severe bone marrow suppression treatment was the best;But compared with rhG-CSF,the using rhGM-CSF group increased significantly in the effect of platele;Two groups of hemoglobin influence were not obvious.Recommended for chemotherapy after the occurrence of severe myelosuppression,preference of rhG-CSF rapid rise of granulocyte,granulocyte is relatively stable after the,such as platelets is still low,adjusted for can be adjusted for the role of increased granulocyte is relatively more moderate,but on platelet increased more obvious effect of rhGM-CSF to continue treatment.At the same time,the lack of refractory granule cells in the specificaction range,by increasing the dosage or the medicine times or granulocyte effect is significant.To the curative effect of drugs,safety,cost-effectiveness of clinical commonly used of two kinds of drugs of ascending granulocyte,cognition of pharmacists and physicians is still inadequate,and there is a certain difference,need to improve the degree of attention,in order to select the appropriate drug and dose in clinical practice,guarantee the rational use of drugs.