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目的对以血小板活性为指导的个体化抗血小板治疗方案的药物经济学评价研究进行总结探讨。方法利用Embase和Medline数据库,遴选自2000年以来发表的相关文献。结果共4项研究纳入分析,均使用决策分析模型比较急性冠状动脉综合征(ACS)患者传统抗血小板治疗(全部患者使用氯吡格雷、普拉格雷或替格瑞洛)与个体化抗血小板治疗方案的成本-效果(效用)。个体化方案以高血小板活性(high on-treatment platelet reactivity,HTPR)为指标,HTPR患者使用普拉格雷或替格瑞洛,非HTPR患者使用氯吡格雷。相比传统方案,个体化抗血小板方案为优势(dominant)或最具成本-效果方案。基线研究结果受药物成本、心血管源性死亡率及HTPR患者比例等因素影响。结论相比传统抗血小板治疗,ACS患者以血小板活性为指导的个体化抗血小板治疗具有更好的成本-效果(效用)。
Objective To summarize the study of pharmacoeconomic evaluation of individualized antiplatelet therapy regimen guided by platelet activity. Methods The Embase and Medline databases were used to select the relevant articles published since 2000. Results A total of 4 studies were included in the analysis, both using a decision analysis model to compare traditional antiplatelet therapy (all patients with clopidogrel, prasugrel or ticagrelor) and individualized antiplatelet therapy in patients with acute coronary syndrome (ACS) The cost of the program - effect (utility). Individualized regimens used high on-treatment platelet reactivity (HTPR) as an index, prasugrel or ticagrelor for HTPR, and clopidogrel for non-HTPR patients. Individualized antiplatelet programs are dominant or most cost-effective compared to traditional approaches. Baseline study results were influenced by factors such as drug costs, cardiovascular mortality, and HTPR proportion. CONCLUSIONS: Patients with ACS have better cost-effectiveness (utility) of individualized antiplatelet therapy directed at platelet activity than conventional antiplatelet therapy.