Evaluation of Efficacy,Safety and Economics of Centralized Procurement Based on Multicentre Real-World Data——Taking Tigecycline as an Example
Objective:The paper compares the efficacy,safety and economics of centralized procurement and original tigecycline in the treatment of patients with bacterial infection to provide evidence for clinical drug selection.Methods:Data of 318 patients treated with centralized procurement(209 cases)and original(109 cases)tigacycline from 3 hospitals from July 2019 to July 2023 were retrospectively collected.The two groups of samples with balanced covariates were obtained by propensity score matching(PSM).The efficacy was evaluated by clinical effective rate,28d mortality rate,bacteriological clearance rate and infection-related indicators,the safety was evaluated by the incidence of adverse reactions and abnormal rate of adverse events,and the economics was evaluated by the cost-minimization analysis.Results:After PSM,the centralized procurement group and the original group included 86 patients respectively.There was no significant difference in clinical effective rate,28d mortality rate,bacteriological clearance rate,WBC,NEUT,NEUT％,hsCRP/CRP,IL-6 and PCT recovery between the two groups(P＞0.05).The proportion of patients whose body temperature returned to the normal range in the original group was higher than that in the centralized procurement group(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the centralized procurement and original research groups(P＞0.05).The incidence of PT extension in the centralized procurement group was higher than that in the original group(P＜0.05),and there was no significant difference in the abnormal rate of other adverse event-related indicators between the groups(P＞0.05).The cost-minimization analysis showed that the cost of tigacycline,total antibacterial drug cost,total drug cost and total hospitalization cost in the centralized procurement group were lower than those in the original group(P＜0.01).Moreover,within the range of parameters for sensitivity analysis,the results were consistent with those of cost-minimization analysis.Conclusions:Centralized procurement and original tigecycline have similar efficacy and safety in the treatment of bacterial infection,and centralized procurement tigecycline has an economic advantage than original tigecycline.
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