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OBJECTIVE:To evaluate the cost-effectiveness of Acarbose in the treatment of type 2 diabetes. METHODS:The CORE diabetes model was employed to evaluate the long-term cost-effectiveness of Acarbose in the treatment of type 2 diabetes. RESULTS:Acarbose treatment prolonged patients' life expectancy by 0.27 years and quality-adjusted life expectancy by 0.26 years,but its cost was 17 081 yuan higher than in the control group. The incremental cost-effectiveness ratio was 62 717 yuan per life expectancy gained and 66 633 yuan per quality-adjusted life expectancy gained. An acceptability curve of cost-effectiveness showed that 76% of the patients would regard that Acarbose is cost-effectiveness when a willingness to pay was 100 000 yuan. CONCLUSION:Acarbose has long-term cost-effectiveness in the treatment of type 2 diabetes.
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Objective To assess the use of medical services by patients with chronic hepatitis B, cirrhosis resulting from hepatitis, or hepatic carcinoma and the composition of the expenses incurred. Methods A survey was made on the use of outpatient and inpatient services as well as the details of medical expenses incurred by 1 395 self-funded patients and patients enjoying social medical insurance in Shanghai. And an analysis was made on the composition of the expenses and direct medical expenses per annum. Results There was no significant difference between the self-funded group and the insurance group in the use of outpatient and inpatient services; in terms of medical expenses, those incurred by the insurance group were 30% to 50% higher than those incurred by the self-funded group; an analysis on the composition of outpatient expenses showed that drug expenses accounted for over 80% and examination and test expenses accounted for over 15%; an analysis on the composition of inpatient expenses showed that drug expenses incurred by the two groups both accounted for 45% to 60% of the total expenses and examination and test expenses accounted for 15% to 25%. Conclusion Social medical insurance reduces the economic burden of individual patients but significantly raises treatment expenses. The key to containing the rise of medical expenses lies in controlling the conversion of hepatitis B to cirrhosis and the irrational growth of inpatient drug expenses and examination and test expenses.
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OBJECTIVE:To discuss the feasibility of the contingent valuation method(CVM)in the field of health care in China,and give some suggestions for the application of CVM.METHODS:CVM in a specific case that was a research on shigellosis patients’willingness to pay(WTP)and willingness to accept(WTA)for shigellosis vaccine in rural area in HeBei Province was carried out.RESULTS:96.42%of the patients answered they will buy shigellosis vaccine,and the accept rate will descend with the price ascending.The highest price that the patients are willing to pay for shigellosis vaccine is16.03yuans,and the lowest price that they are unwilling to pay for it is39.72yuans.CONCLUSION:Using CVM in the research of WTP and WTA for shigellosis vaccine is feasible.The application of CVM in more fields in health care in China remains to be further study.
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Objective To investigate the prevalence of pulmonary acariasis among the employees working on traditional Chinese medicinal materials and observe the effect of treatment. Methods History inquiry, detection of mites in sputum, blood examination for eosinophils and specific antibodies, x-ray chest film were carried out for 327 workers involving in traditional Chinese medicinal materials. Mites were found in sputum in 121 persons who were then treated with metronidazole, twice a day with a daily dosage of 0.8g for seven days as a course of treatment. Two courses were conducted with an interval of 7-10 day. Prevalence and morbidity in different groups of occupation, age, and sex were analyzed. Results The overall infection rate of mites in sputum was 37.0% (121/327) with an average morbidity of 12.5% (41/327). Among the four types of worker investigated, the highest infection rate (51.8%), and morbidity (18.6%) were in those working in transfer warehouse; the second highest infection rate (40.7%) and morbidity (15.7%) were in employees in factory of Chinese traditional medicine. Both groups showed a significant difference with others(?2inf=11.36,P0.05). After treatment with metronidazole, 88.4% showed negative in sputum examination for mites and the efficacy of the treatment for pulmonary acariasis was 92.3%. Conclusions Employees engaged in traditional Chinese medicinal materials are one of the groups at the highest risk of pulmonary acariasis. Metronidazole is effective in treating the infection.