国内前列腺癌经济学评价研究现状  

Current Situation of Economic Evaluation on Prostate Cancer in China

作　　者：刘世贤 李顺平 窦蕾[1,2,3] 王凯旋 史钊[1,2,3] 王瑞雪 LIU Shixian(Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan,Shandong,250012,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,山东济南250012 [2]国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),山东济南250012 [3]山东大学健康偏好研究中心,山东济南250012

出　　处：《医学与社会》2023年第1期75-79,共5页Medicine and Society

基　　金：美国中华医学基金会项目,编号为CMB14-195。

摘　　要：目的:了解国内前列腺癌经济学评价研究进展,以期为前列腺癌筛查、治疗和支付决策提供参考。方法:系统检索PubMed、Web of Science、Embase、Scopus、知网、维普、万方数据库,搜集前列腺癌相关的经济学评价研究,检索时间截至2021年9月30日。结果:共检索相关文献90篇,最终纳入18篇。现有研究显示,前列腺特异抗原筛查的经济性较好;对于直肠指检正常、前列腺特异抗原4-10 ng/mL的男性,前列腺健康指数≥35时,诊断绝对经济。雄激素剥夺治疗+多西他赛治疗转移性激素敏感性前列腺癌具有成本-效果,恩扎卢胺不具有成本-效果,雄激素剥夺治疗+阿比特龙成本-效果尚未达成一致结论。去势抵抗性前列腺癌治疗方面,阿比特龙成本-效果更优。结论:国内前列腺癌经济学评价在成本界定和健康效用值选择等方面仍有较大的优化空间,缺乏多种筛查或治疗方案经济性的综合比较。Objective:To inform the progress in studies on economic evaluation of prostate cancer in China,so as to provide references for screening,treatment,and payment decision-making.Methods:PubMed,Web of Science,Embase,Scopus,CNKI,VIP and WanFang Data databases were searched systematically to collect economic evaluations related to prostate cancer.The retrieval time was up to September 30,2021.Results:A total of 90 related literatures were retrieved,and finally 18 were included.Available literature showed that prostate specific antigen screening was economic.The prostate health index(PHI)cut-off scores was greater than or equal to 35,PHI diagnostic strategy was absolutely economic for men with normal digital rectal examination and prostate specific antigen 4-10 ng/mL.Androgen deprivation therapy(ADT)plus docetaxel was cost-effectiveness for metastatic hormone-sensitive prostate cancer,enzalutamide was uneconomic,and the cost-effectiveness of ADT plus abiraterone had not reached a consensus.Abiraterone was more cost-effectiveness in the treatment of castration-resistant prostate cancer.Conclusion:Economic evaluation of prostate cancer in China still has a large optimization space in terms of cost definition and health utility value selection,and lacks comprehensive economic comparison of various screening or treatment schemes.

关 键 词：卫生经济学评价 前列腺癌 筛查 治疗 

分 类 号：R195.4[医药卫生—卫生统计学]