奥希替尼治疗晚期非小细胞肺癌的药物经济学系统评价  

Pharmacoeconomic Systematic Review of Osimertinib for Advanced Non-small Cell Lung Cancer

作　　者：米雪 苏雪龙 孙维红[4] 李佳萌 高华[4] MI Xue;SU Xuelong;SUN Weihong;LI Jiameng;GAO Hua(School of Pharmacy,Ningxia Medical University,Yinchuan 750004,China;Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases,College of Stomatology,Xi’an Jiaotong University,Xi’an 710004,China;Dept.of Pediatric Dentistry,Stomatological Hospital,Xi’an Jiaotong University,Xi’an 710004,China;Dept.of Pharmacy,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学药学院,银川750004 [2]西安交通大学口腔医学院陕西省牙颌面疾病临床研究中心,西安710004 [3]西安交通大学口腔医院儿童口腔科,西安710004 [4]宁夏医科大学总医院药剂科,银川750004

出　　处：《中国药房》2021年第6期713-719,共7页China Pharmacy

摘　　要：目的:系统评价奥希替尼治疗晚期非小细胞肺癌(NSCLC)的经济性,为临床应用及卫生和医保决策者提供参考。方法:计算机检索PubMed、Embase、Cochrane图书馆、Health Technology Assessment、中国知网、万方数据、维普网和中国生物医学文献数据库等数据库,查询自建库至2020年4月公开发表的有关奥希替尼治疗晚期NSCLC的相关药物经济学研究,经筛选并提取相关资料后,采用健康经济学研究质量评估工具(QHES)评估纳入研究的质量,采用描述性分析方法系统评价纳入文献的经济学研究结果。结果与结论:共纳入10项研究,来自7个不同的国家;纳入文献的QHES评分为73~93分,平均86.8分,研究质量总体较高。10项研究均为成本-效果分析,其中一线治疗6项、二线治疗4项;6项研究报告了成本贴现率;仅有1项研究采用奥希替尼降价后的价格进行评估分析。奥希替尼作为一线治疗方案与其他表皮生长因子受体-络氨酸激酶抑制剂(EGFR-TKI)类药物相比,来自不同国家的6项研究结果均显示奥希替尼不具有成本-效果优势;奥希替尼二线治疗对比化疗方案的成本-效果则存在一定争议。对于晚期NSCLC患者,经国家集中谈判降价后的奥希替尼二线治疗相比于化疗方案在我国医疗服务体系下更具有成本-效果优势,而降价前的奥希替尼一线治疗相比于其他EGFR-TKI类药物则不具备成本-效果优势。OBJECTIVE:To systematically review the economics of osimertinib for advanced non-small cell lung cancer(NSCLC),and to provide the reference for clinical application and healthcare decision makers.METHODS:Retrieved from PubMed,Embase,the Cochrane Library,Health Technology Assessment,CNKI,Wanfang database,VIP,CBM,etc.,pharmacoeconomic studies on osimertinib in the treatment of advanced NSCLC were collected from the inception to Apr.2020.After screening and extracting relevant data,the quality of the included studies was evaluated by using the Quality of Health Economics Studies(QHES),and the economic research results of the included literatures were systematically evaluated by using descriptive analysis method.RESULTS&CONCLUSIONS:A total of 10 studies from 7 different countries were included;QHES scores of the included literatures were 73-93,with an average of 86.8,and the quality of the researches was generally high.All the10 studies were cost-effectiveness analysis,including 6 first-line treatment,4 second-line treatment.Six studies reported the cost discount rate;only one study used the cost of osimertinib after price reduction for evaluation and analysis.Compared with other epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKI),six studies from different countries showed that osimertinib as the first-line treatment drug had no cost-effectiveness advantage;cost-effectiveness of second-line treatment of osimertinib was controversial,compared to chemotherapy.For advanced NSCLC patients,the second-line treatment of osimertinib after the national centralized negotiation of price reduction has a more cost-effectiveness advantage in China’s medical service system,while the first-line treatment of osimertinib before price reduction does not have this advantage compared with other EGFR-TKI drugs.

关 键 词：奥希替尼 晚期非小细胞肺癌 成本-效果分析 系统评价 

分 类 号：R956[医药卫生—药学] R979.1