ABSTRACT
OBJECTIVE To provide reference for the prevention and treatment of hepatitis C and the formulation and improvement of medical insurance payment policy for direct-acting antiviral （DAA） drugs. METHODS An questionnaire survey was conducted among the patients who received hepatitis C treatment in a third-grade class-A hospital in Sichuan province from 2019 to 2020 and enjoyed Chengdu medical insurance policy. The patients’ hepatitis C treatment and satisfaction with the medical insurance policy for DAA drugs were compared before and after DAA drugs were included in the medical insurance list. RESULTS A total of 203 patients effectively responded among 644 investigated patients. In terms of treatment plans， although there were significant differences in the treatment plan between patients who saw a doctor in 2019 and 2020 （P＜0.05）， the vast majority of patients were cured within the course of treatment （200 cases， 98.52%）， and there were no obvious adverse reactions （193 cases， 95.07%）. In terms of economic burden， the out-of-pocket costs and economic burden of patients treated with DAA drugs in 2020 were significantly lower than those treated with DAA drugs in 2019 （P＜0.05）； in terms of patient services， 78.82% of patients received expert consultation services from designated medical institutions， but 9.85% of patients still did not receive any patient services provided by the hospital. In terms of satisfaction with outpatient reimbursement policy， the overall satisfaction of patients who saw a doctor in 2020 （95.37%） was significantly higher than those who saw a doctor in 2019 （81.05%）（P＜0.05）. CONCLUSIONS The surveyed patients with hepatitis C obtain good efficacy after DAA drugs treatment， and are satisfied with the medical insurance policy of DAA drugs， but the standardized management of patient services in designated medical institutions is insufficient.
ABSTRACT
OBJECTIVE：To eval uate therapeutic effic acy，safety and economical efficiency of Ginkgolide injection versus Butylphthalide injection in the treatment of ischemic stroke. METHODS ：Among the GISAA of Ginkgolide injection in the treatment of ischemic stroke of large-artery atherosclerosis ，106 patients who were given Ginkgolide injection+Asprin enteric-coated tablets but did not use butylphthalide in any dosage in previous trial group were selected as ginkgolide group ；56 patients who were given Butylphthalide injection+Ginkgolide injection+Asprin enteric-coated tablets in previous placebo group were selected as control group. The effects ，safety and economical efficiency were compared between 2 groups. Effect indexes included recurrence rate ， mortality，NIHSS score ，modified Rankin score （mRS），Barthel index and comprehensive efficacy. The safety indexes included incidence of bleeding event and adverse event during treatment. Cost-minimization analysis was used for economic evaluation. RESULTS：There was no statistical difference in recurrence rate ，mortality，NIHSS score ，the proportion of subjects with mRS 0-2，Barthel index ，comprehensive efficacy and the incidence of adverse event between 2 groups on 28th day after treatment （P＞ 0.05）. NIHSS score of ginkgolide group was better than that of control group on 7th and 14th day （P＜0.05）. Results of cost-minimization analysis showed that total cost of ginkgdide group was （13 768.19±4 981.54）yuan on 14th day of treatment ， which was significantly lower than （22 578.52±7 523.23）yuan of control group （P＜0.01）. The results of sensivity analysis indicated that the minimum lost analysis was stable. CONCLUSIONS ：For the treatment of ischemic stroke ，ginkgolide+aspirin is similar to butylphthalide+aspirin in improving clinical outcome and safety of 28 days，but is better than it in short-term efficacy of improving neurological deficit ， and better short-term economical efficiency.