تحلیل هزینه–اثربخشی درمان نگهدارنده با متادون و بوپرنورفین به‌منظور پیش‌گیری از بیماری ایدز در معتادان تزریقی (مطالعه موردی: مرکز‌های منتخب ترک اعتیاد تحت نظارت دانشگاه علوم پزشکی و خدمات بهداشتی درمانی شیراز)

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار گروه مدیریت خدمات بهداشتی درمانی دانشگاه آزاد اسلامی شیراز

2 کارشناس ارشد مدیریت خدمات بهداشتی درمانی، گروه مدیریت خدمات بهداشتی و درمانی، دانشگاه آزاد اسلامی واحد علوم و تحقیقات استان فارس

3 استادیار گروه مدیریت خدمات بهداشتی و درمانی دانشگاه آزاد اسلامی مرودشت

چکیده

مقدمه: پژوهش حاضر به تحلیل مقایسه‌ای هزینه-اثربخشی درمان نگهدارنده با داروهای متـادون و بوپرنورفین به‌منظور احتمال پیش‌گیری از انتقال موارد جدید بیماری ایدز در معتادان پرداخته است.
روش پژوهش: پژوهش حاضر مقطعی است و در آن 315 معتاد مراجعه‌کننده به یک مرکز دولتی و یک مرکز خصوصی ارائه‌کننده خدمات درمان نگهدارنده با داروهای متادون و بوپرنورفین تحت نظارت دانشگاه علوم پزشکی و خدمات بهداشتی درمانی شیراز به‌صورت ارزیابی قبل و بعد از مداخله بدون گروه کنترل در طول یک‌ سال بدون نرخ تنزیل مورد بررسی قرار گرفته است. احتمال پیش‌گیری از انتقال بیماری ایدز به‌عنوان واحد اثربخشی با استفاده از درخت تصمیم‌گیری و نرم‌افزار tree age نسخه 2010 برای رفتارهای پرخطر تزریقی و جنسی در قبل و بعد از مراجعه به مرکز محاسبه شده و سپس با استفاده از روش تحلیل حساسیت یک‌طرفه مورد بررسی قرار گرفته است.
یافته‌ها: داروی بوپرنورفین هزینه کم‌تر و اثربخشی بیشتری نسبت به داروی متادون دارد. نسبت هزینه-اثربخشی داروی بوپرنورفین نسبت به داروی متادون معادل 60/861ر307ر705ر17- ریال بدست آمد. هم‌چنین، داروی بوپرنورفین و متادون، به ترتیب، موجب اجتناب از 14 و 47 مورد جدید ابتلا به بیماری ایدز شده است.
نتیجه‌گیری: با توجه به متفاوت بودن نتایج پژوهش باید در مورد استفاده از این دارو‌ها در بُعد منطقه‌ای و ملی احتیاط شده و تصمیم‌گیری در ارتباط با این موضوع نیاز به مطالعه و بحث بیشتری دارد.

کلیدواژه‌ها


عنوان مقاله [English]

The Analysis of Cost-Effectiveness of Methadone and Buprenorphine Maintenance Treatment for Preventing HIV Infection in Drug-Injection Users (A Case Study: The Selected Withdrawal Centers under the Supervision of Shiraz University of Medical Sciences)

نویسندگان [English]

  • S. Hesam 1
  • N. Honarvar 2
  • Sh. Vahdat 3
1 Assistant Professor, Department of Health Care Services Management, Islamic Azad University, Shiraz Branch
2 M. A. in Health Care Services Management, Department of Health Care Services Management, Islamic Azad University of Science and Research of Fars
3 Assistant Professor, Department of Health Care Services Management, Islamic Azad University, Marvdasht Branch
چکیده [English]

Introduction: The present study has carried out a comparative analysis on the cost- effectiveness of maintenance treatment with Methadone and Buprenorphine to prevent the possibility of transmission of new cases from HIV infection among drug users.
Method: This study is cross-sectional, and 315 drug users who referred to a governmental and a private centers that provide services for maintenance treatment with Methadone and Buprenorphine under the supervision of Shiraz University of Medical Sciences have been studied in the form of evaluating after and before intervention without control group during one year and without the discount rate. The possibility of prevention from HIV transmission as a unit of effectivenesshas been calculated by using Decision Tree and Tree Age Software Version 2010 for high risk sexual and drug-injection behaviors before and after referral to the centers, and then it has been investigated via one-way analysis of sensitivity.
Results: Buprenorphine costs less than Methadone, and it has more effectiveness. The cost- effectiveness ratio of Buprenorphine in relation to Methadone was -17,705,307,861.60 Rials. Moreover, Buprenorphine and Methadone have caused the prevention of 14 and 47 new cases from infection with HIV, respectively.
Conclusion: Regarding the distinction between the results of the research, we have to take precautions in using these drugs in the national and regional dimensions, and the decision-making related to this issue requires further study and discussion.

کلیدواژه‌ها [English]

  • Buprenorphine
  • cost
  • effectiveness
  • HIV
  • Methadone
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