만성 B형간염 진단 환자의 항바이러스제 처방양상
Prescribing Patterns of Antivirals for Chronic Hepatitis B
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This study was aimed to examine the prescribing patterns of antivirals in chronic hepatitis B(CHB)for outpatients. National Health Insurance adjudicated claims data(total 1,426,065 claims) dated March 19, 2008 submitted from nationwide healthcare providers to Health Insurance Review and Assessment Service were used in this study. 2,965 claims included CHB diagnosis(ICD-10 code B18.0 and B18.1). 44.2%(1,311) of CHD related claims included antiviral prescription such as lamivudine, clevudine, adefovir and entecavir which were currently available. Lamivudine, adefovir,clevudine and entecavir shared 54.9%, 19.9%, 13.2% and 11.9%, respectively among antiviral prescriptions. Adefovir and entecavir 1mg presumed as the 2nd line therapy for HBV resistant cases were shared 23.3% of overall antiviral prescriptions. There were statistically significant difference in prescription patterns according to age and instititution type: Lamivudine usage was higher in younger(< 20) and older age group(> 70 year old) than others(p = 0.016), and adefovir and entecavir which were relatively newer antivirals had higher prescription rate in higher level of institutions such as the 3rd level hospital than others(p < 0.001). This study would be of help to makeappropriate drug therapy plan for CHB patients.
Abstract
This study was aimed to examine the prescribing patterns of antivirals in chronic hepatitis B(CHB)for outpatients. National Health Insurance adjudicated claims data(total 1,426,065 claims) dated March 19, 2008 submitted from nationwide healthcare providers to Health Insurance Review and Assessment Service were used in this study. 2,965 claims included CHB diagnosis(ICD-10 code B18.0 and B18.1). 44.2%(1,311) of CHD related claims included antiviral prescription such as lamivudine, clevudine, adefovir and entecavir which were currently available. Lamivudine, adefovir,clevudine and entecavir shared 54.9%, 19.9%, 13.2% and 11.9%, respectively among antiviral prescriptions. Adefovir and entecavir 1mg presumed as the 2nd line therapy for HBV resistant cases were shared 23.3% of overall antiviral prescriptions. There were statistically significant difference in prescription patterns according to age and instititution type: Lamivudine usage was higher in younger(< 20) and older age group(> 70 year old) than others(p = 0.016), and adefovir and entecavir which were relatively newer antivirals had higher prescription rate in higher level of institutions such as the 3rd level hospital than others(p < 0.001). This study would be of help to makeappropriate drug therapy plan for CHB patients.
참고문헌 (14)
- 김도영, "만성 B형 간염 치료의 최신지견", 제 10회 연세대학교 의과대학 내과 연수강좌 (2009)
- European Association for the Study of the Liver, "EASL Clinical Practice Guidelines: Management of chronic hepatitis B", J Hepatol, 50(2), pp.227~242 (2009)
- 최연호, "학동기전 정상아동에서의 B형간염 항원 및 항체 보유율에 관한 연구", 대한소아과학회지, 39(9), pp.1254~1259 (2005)
- 국민건강영양조사 제3기 (2005) 총괄보고서, "보건복지부한국보건사회연구원", ~ (2006)
- 한철주, "만성 B형간염의 자연경과와 예후", 소화기연관학회 춘계학술대회 (2005)
- "ICD-10(the Tenth Edition of the International Classification of Diseases)" (2009)[URL]
- "건강보험DB 질병통계" (2009), 국민건강보험공단[URL]
- 정영호, "5대 사망질병의 사회·경제적 비용 추계: 2001년", 보건복지포럼, 79, pp.55~65 (2003)
- 양봉민, "B형 간염 바이러스 관련 질환의 사회적 비용 추계", 보건경제연구, 6(2), pp.117~142 (2000)
- 전계식, "한국에 있어서 성과 연령으로 본 질병동향", 자연과학연구소논문지, 4(1), pp.1~6 (1999)
- 이관식, "만성 B형간염의 치료", 대한의사협회지, 52(8), pp.831~837 (2009), 대한의사협회
- Lok AS, "Chronic hepatitis B", Hepatology, 45, pp.507~539 (2007)
- "ATC(Anatomical Therapeutic Classification) Code" (2009)[URL]
- Lee YS, "Increased risk of adefovir resistance in patients with lamivudine-resistant chronic hepatitis B after 48 weeks of adefovir dipivoxil monotherapy", HEPATOLOGY, 43(6), pp.1385~1391 (2006), JOHN WILEY & SONS INC