药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
Adverse Drug Reactions Journal
2015年
4期
247-252
,共6页
李晓玲%闫素英%王育琴%赵程程%陆璐
李曉玲%閆素英%王育琴%趙程程%陸璐
리효령%염소영%왕육금%조정정%륙로
循证医学%经济学,药学%血管紧张素Ⅱ2 型受体拮抗剂
循證醫學%經濟學,藥學%血管緊張素Ⅱ2 型受體拮抗劑
순증의학%경제학,약학%혈관긴장소Ⅱ2 형수체길항제
Evidence-based medicine%Pharmacoeconomics%Economics,pharmaceutical%AngiotensinⅡtype 2 receptor blockers
目的：以血管紧张素Ⅱ受体拮抗剂（ARB）类药物为模板，探讨我国基本药物的遴选方法。方法以《中国高血压防治指南2010》推荐的 ARB 类药物氯沙坦、缬沙坦、厄贝沙坦、替米沙坦、坎地沙坦和奥美沙坦为待评价药物，参考泰国学者提出的 ISafE 法，采用文献检索、查阅说明书和/或半定量评分法，对每种药物的信息量（I）、安全性（S）、用药便捷性（af）和有效性（E）等4个指标赋值。各项指标的权重及赋值方法经征求我国临床医学、药学和流行病学专家的意见确定，安全性和有效性权重各40%，信息量与用药便捷性权重各10%。计算每种药物的 ISafE 得分，以每日用药费用与 ISafE 得分的比值作为基本药物价格指数（EMCI）并进行排名，EMCI 值越小，越值得推荐。结果6种待评价药物的信息量赋值由高到低依次为氯沙坦、缬沙坦、替米沙坦、厄贝沙坦、坎地沙坦、奥美沙坦；有效性依次为奥美沙坦、替米沙坦、缬沙坦、厄贝沙坦、坎地沙坦、氯沙坦；安全性依次为为替米沙坦、奥美沙坦、厄贝沙坦、坎地沙坦、缬沙坦、氯沙坦；用药便捷性赋值相同；ISafE 分值从高至低依次为替米沙坦、奥美沙坦、厄贝沙坦、缬沙坦、氯沙坦和坎地沙坦。国产药中缬沙坦 EMCI 值最小，与该药为纳入我国现行基本药物目录的唯一 ARB 类药物吻合，合资药中以替米沙坦 EMCI 值最小。结论经优化和本土化后的 ISafE 法具有信息客观、操作性强的特点，可为我国基本药物遴选方法的进一步完善提供参考。
目的：以血管緊張素Ⅱ受體拮抗劑（ARB）類藥物為模闆，探討我國基本藥物的遴選方法。方法以《中國高血壓防治指南2010》推薦的 ARB 類藥物氯沙坦、纈沙坦、阨貝沙坦、替米沙坦、坎地沙坦和奧美沙坦為待評價藥物，參攷泰國學者提齣的 ISafE 法，採用文獻檢索、查閱說明書和/或半定量評分法，對每種藥物的信息量（I）、安全性（S）、用藥便捷性（af）和有效性（E）等4箇指標賦值。各項指標的權重及賦值方法經徵求我國臨床醫學、藥學和流行病學專傢的意見確定，安全性和有效性權重各40%，信息量與用藥便捷性權重各10%。計算每種藥物的 ISafE 得分，以每日用藥費用與 ISafE 得分的比值作為基本藥物價格指數（EMCI）併進行排名，EMCI 值越小，越值得推薦。結果6種待評價藥物的信息量賦值由高到低依次為氯沙坦、纈沙坦、替米沙坦、阨貝沙坦、坎地沙坦、奧美沙坦；有效性依次為奧美沙坦、替米沙坦、纈沙坦、阨貝沙坦、坎地沙坦、氯沙坦；安全性依次為為替米沙坦、奧美沙坦、阨貝沙坦、坎地沙坦、纈沙坦、氯沙坦；用藥便捷性賦值相同；ISafE 分值從高至低依次為替米沙坦、奧美沙坦、阨貝沙坦、纈沙坦、氯沙坦和坎地沙坦。國產藥中纈沙坦 EMCI 值最小，與該藥為納入我國現行基本藥物目錄的唯一 ARB 類藥物吻閤，閤資藥中以替米沙坦 EMCI 值最小。結論經優化和本土化後的 ISafE 法具有信息客觀、操作性彊的特點，可為我國基本藥物遴選方法的進一步完善提供參攷。
목적：이혈관긴장소Ⅱ수체길항제（ARB）류약물위모판，탐토아국기본약물적린선방법。방법이《중국고혈압방치지남2010》추천적 ARB 류약물록사탄、힐사탄、액패사탄、체미사탄、감지사탄화오미사탄위대평개약물，삼고태국학자제출적 ISafE 법，채용문헌검색、사열설명서화/혹반정량평분법，대매충약물적신식량（I）、안전성（S）、용약편첩성（af）화유효성（E）등4개지표부치。각항지표적권중급부치방법경정구아국림상의학、약학화류행병학전가적의견학정，안전성화유효성권중각40%，신식량여용약편첩성권중각10%。계산매충약물적 ISafE 득분，이매일용약비용여 ISafE 득분적비치작위기본약물개격지수（EMCI）병진행배명，EMCI 치월소，월치득추천。결과6충대평개약물적신식량부치유고도저의차위록사탄、힐사탄、체미사탄、액패사탄、감지사탄、오미사탄；유효성의차위오미사탄、체미사탄、힐사탄、액패사탄、감지사탄、록사탄；안전성의차위위체미사탄、오미사탄、액패사탄、감지사탄、힐사탄、록사탄；용약편첩성부치상동；ISafE 분치종고지저의차위체미사탄、오미사탄、액패사탄、힐사탄、록사탄화감지사탄。국산약중힐사탄 EMCI 치최소，여해약위납입아국현행기본약물목록적유일 ARB 류약물문합，합자약중이체미사탄 EMCI 치최소。결론경우화화본토화후적 ISafE 법구유신식객관、조작성강적특점，가위아국기본약물린선방법적진일보완선제공삼고。
Objective To investigate the method of essential medicines selection in China. The angiotensin II receptor antagonist ( ARB ) drugs were taken as templet. Methods ARB drugs recommended by 〞 Guidelines for the prevention and control of hypertension in China 2010〞 including losartan,valsartan,irbesartan,telmisartan,candesartan and olmesartan were included as the intended evaluating drugs. Each drugˊs information(I),safety(S),administration restriction and frequency of drug administration(af),and efficacy(E)scores were evaluated respectively and were put together as ISafE. The weight and evaluation of every index were confirmed by the suggestions of specialists in clinical medicine,pharmacy,and epidemiology in China. The weight of safety and efficacy were 40% ,respectively, and the information and administration restriction and frequency of drug administration were 10% , respectively. The score of each drugˊs ISafE was calculated. The ratio of each drugˊs daily medication costs to score of ISafE was the essential medicine cost index( EMCI). The EMCI of each drug was ranked according to the value. The lower the drugˊ s EMCI value, the drug would be more likely to be recommended. Results The scores of information in the 6 ARB drugs from high to low in turn were losartan,valsartan,telmisartan,irbesartan,candesartan,and olmesartan. The scores of efficacy in the 6 ARB drugs from high to low in turn were olmesartan,telmisartan,valsartan,irbesartan,candesartan,and losartan. The scores of safety in the 6 ARB drugs from high to low in turn were telmisartan,olmesartan, irbesartan,candesartan,valsartan,and losartan. The 6 ARB drugs had the same scores in af value. The scores of ISafE in the 6 ARB drugs from high to low in turn were telmisartan,olmesartan,irbesartan, valsartan,losartan,and candesartan. The EMCI value of valsartan was the lowest among the domestic ARB <br> drugs. The above-mentioned result was consistent with that of valsartan,which was the only ARB drug enrolled into the Chinese essential medicine list. The EMCI value of telmisartan was the lowest among the joint-stock ARB drugs. Conclusion ISafE method,which has been optimized and localized,has the characteristics of objective information and high maneuverability and could provide reference for improvement of the selection of essential drugs in China.
