Pharmacoeconomic Analysis of Penehyclidine Hydrochloride and Atropine in the Treatment of Acute Organophosphorus Poisoning / 中国药房

ABSTRACT

OBJECTIVE:To evaluate the economics of penehyclidine hydrochloride and atropine in the treatment of acute organophosphorus poisoning (AOPP).METHODS:The information of 118 AOPP patients were collected and divided into group A (59 cases) and B (59 cases) according to therapy plan.There were 22 cases of mild poisoning,20 cases of moderate poisoning and 17 cases of severe poisoning in group A.There were 21 mild cases,21 moderate cases and 17 severe cases in group B.Based on routine treatment,group A was given Penehyclidine hydrochloride injection intramuscularly with initial dose of 1 mg (mild),2 mg (moderate) and 4 mg (severe).Group B was given Atropine sulfate injection intravenously,with initial dose of 2 mg (mild),5 mg (moderate) and 10 mg (severe).Both received maintenance treatment according to patients condition and stopped taking medicine after symptoms disappeared.Clinical efficacies,the time of acetylcholinesterase recovery and ADR were observed in 2 groups.The economics of therapy plans for mild,moderate and severe poisoning were evaluated in 2 groups by cost-effectiveness analysis.RESULTS:There was no statistical significance in total response rate of mild poisoning or the time of acetylcholinesterase recovery between 2 groups (P＞0.05).Total effective rates of moderate and severe poisoning in group A were significantly higher than group B,and the time of acetylcholinesterase recovery was significantly shorter than group B,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR in mild,moderate and severe poisoning patients (P＞0.05).Cost-effectiveness ratio of penehyclidine hydrochloride was similar to that of atropine in mild poisoning patients;that of penehyclidine hydrochloride were significantly lower than that of atropine in moderate and severe patients.It was inline with the results of sensitivity analysis.CONCLUSIONS:Based on routine treatment,penehyclidine hydrochloride is similar to atropine in therapeutic efficacy of AOPP and the time of acetylcholinesterase recovery.For moderate and severe AOPP patients,penehyclidine hydrochloride is significantly better than atropine in improving therapeutic efficacy and the time of acetylcholinesterase recovery.The safety of 2 drugs are satisfactory;penehyclidine hydrochloride possesses cost-effectiveness advantage.