| Atrial fibrillation(abbreviated clinically as atrial fibrillation)is one of the most common diseases in my country.The survey data shows that the main reason for the deterioration of the quality of life of patients with atrial fibrillation is thromboembolic complications,that is,stroke is one of the most common types of complications.Some people believe that the risk of stroke caused by atrial fibrillation is higher than other factors such as high blood pressure and hyperlipidemia.That is,if a patient is diagnosed with atrial fibrillation,the probability of stroke will be significantly higher than that of patients without such diseases.Atrial fibrillation stroke often significantly reduces the patient’s quality of life and increases economic costs.In recent years,a large number of clinical studies have confirmed that if the incidence of stroke is to be fundamentally reduced,the best way is to prevent the occurrence of atrial fibrillation.In fact,in recent years,because of the extensive recommendation of many authoritative experts,the traditional anticoagulant drug warfarin or the new anticoagulant drug rivaroxaban are usually taken clinically to prevent and treat atrial fibrillation stroke.It has been confirmed that these two drugs can significantly reduce the incidence of stroke disease in patients.However,during the period of taking warfarin,patients need to monitor blood coagulation and other related indicators at the designated medical institution within the specified time,so as to adjust the dosage according to the results of the indicator check.This process may need to be repeated many times,which is laborious and time-consuming.The poor compliance limits its widespread use in clinical practice.Although the new anticoagulant rivaroxaban can effectively compensate for the above-mentioned shortcomings of warfarin,it is expensive and expensive in treatment,which has become a disadvantage of its application.In this way,how to weigh the pros and cons and determine the selection of reasonable atrial fibrillation stroke prevention and treatment drugs has become an important issue that people’s health has to face and needs to be solved urgently.Based on the current economic development in my country,this study uses the European heath-related quality of life questionnaire 5 dimensions(EQ-5D)and the Stroke-specific quality of life(SS)for the first time.-QOL)Two tables are used to score patients with atrial fibrillation stroke,and the results of the scores are used as the effect indicators.The economic value of warfarin and rivaroxaban is systematically compared and evaluated,and it is expected that health resources can be rationally allocated And provide data support to guide clinical medication.In this study,a total of 228 patients with atrial fibrillation and stroke were selected according to the enrollment screening criteria.According to different clinical drug treatment programs,patients with atrial fibrillation stroke were divided into two groups:group A(n=114 cases)and group B(n=114 cases).Group A took warfarin and group B took rivaroxaban.According to the follow-up results,clinical indicators were judged and the treatment safety evaluation was made.The test results showed that the total effective rates of the two groups A and B were 97.4%and 98.7%,respectively,and the incidence of adverse reactions was 44.7%and 42.1%,respectively.There was no difference between the two groups.Using cost-effectiveness analysis and sensitivity analysis,two pharmacoeconomic research methods are used to evaluate and analyze the preventive treatment plans and treatment effects of these two atrial fibrillation stroke drugs.A questionnaire survey method is used to carry out incremental analysis of the plan,compare it with my country’s per capita GDP,and determine the willingness-to-pay(WTP).The content of the questionnaire includes using the options covered by the EQ-5D and SS-QOL scales to score patients,and calculate the health output index based on the score results:Quality adjusted life years(QALYs).QALYs indicators can accurately reflect the improvement status of patients’ quality of life and health.The study time limit is assumed to be 10 years,and the QALY for one year is calculated,and the calculation result for 10 years is derived from this.Because the changes of the investigation parameters can affect the research results,sensitivity analysis should also be performed to ensure that the experimental results are more true and reliable.This study focuses on sensitivity analysis from three aspects:a 10%reduction in the cost of expensive drugs,an increase in inspection fees by 7%,and a discount rate.The results of the study show that the incremental cost-effective ration(ICER)of the two anticoagulant drugs,rivaroxaban and warfarin,are 485865 yuan,599640 yuan,and 520412 yuan,respectively,which are greater than my country’s per capita in 2020.3 times of GDP.The cost factor of the drug price is one of the most influential factors in the sensitivity analysis.Even if the drug is reduced by 10%,the incremental cost-effectiveness ratio(ICER)of the drug compared to warfarin is still greater than the WTP threshold in the region.The sensitivity analysis result It is basically consistent with the cost-effectiveness analysis.The study shows that at the current economic level in my country,with the exception of a few developed cities such as Shenzhen,Wuxi,and Zhuhai,ICER in other regions is still greater than the WTP threshold in this region.This indicates that the new anticoagulant drug rivaroxaban is still available in most regions of my country.There is no cost advantage. |
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