Cost-effectiveness Analysis of 4 Kinds of Protease Inhibitor Preventing Hyperamylasemia and Pancreatitis after ERCP of Choledocholithiasis Patients / 中国药房

ABSTRACT

OBJECTIVE:To evaluate the economics of somatostatin,ulinastatin,octreotide and gabexate preventing hyperamy-lasemia and pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). METHODS:Medical records of 316 cho-ledocholithiasis patients underwent ERCP were selected from our hospital during Jul. 2008-Apr. 2016,and then divided into blank control group(58 cases),somatostatin group(64 cases),ulinastatin group(65 cases),octreotide group(68 cases)and gabexate group (61 cases) according to the use of protease inhibitor. Before ERCP,blank control group received routine treatment as fast-ing,parenteral nutrition support,acid suppression,etc. Based on it,other 4 drug groups received prophylactic drug use according to package inserts 6 h before ERCP. The incidence of hyperamylasemia and pancreatitis after ERCP,VAS scores 3,24,48 h after surgery and the occurrence of ADR were compared among 5 groups. The cost-effectiveness analysis was used to evaluate the eco-nomics of therapy plans in each group. RESULTS:Compared with blank control group,hospitalization time of somatostatin group, ulinastatin group,octreotide group and gabexate group were shortened significantly;the incidence of hyperamylasemia and pancre-atitis were significantly decreased;VAS score 3,24,48 h after surgery were significantly decreased,with statistical significance (P0.05). The cost-effectiveness ratio of somatostatin group was the lowest and has cost-effec-tiveness advantage. The results were supported by incremental cost-effectiveness and sensitivity analysis. CONCLUSIONS:Soma-tostatin,ulinastatin,octreotide and gabexate can significantly prevent the occurrence of hyperamylasemia and pancreatitis after ER-CP,and relieve pain with good safety. Somatostatin can achieve the best therapeutic efficacy at the lowest cost,so it is the best plan for hyperamylasemia and pancreatitis after ERCP.