抗新型冠状病毒感染药物经济学评价的系统评价  

Economic evaluation of anti-novel coronavirus infection drugs:a systematic review

作　　者：罗冰星 陶颖 翁俊岭[1,2] 连代 严俊涛 李福明 肖敦明 杨毅[1,2] 陈英耀 LUO Bingxing;TAO Ying;WENG Junling;LIAN Dai;YAN Juntao;LI Fuming;XIAO Dunming;YANG Yi;CHEN Yingyao(School of Public Health,Fudan University,Shanghai 200032,P.R.China;National Health Commission Key Laboratory of Health Technology Assessment,Fudan University,Shanghai 200032,P.R.China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]国家卫生健康委员会卫生技术评估重点实验室,复旦大学,上海200032

出　　处：《中国循证医学杂志》2023年第5期549-554,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价国内外抗新型冠状病毒感染药物的经济评价研究,为临床合理用药提供参考。方法计算机检索PubMed、Cochrane Library、EMbase、Web of Science、INAHTA、SinoMed、WanFang Data、CNKI数据库,检索时限为2020年1月1日—2023年3月25日,搜集抗新型冠状病毒感染药物经济学评价研究。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,进行描述性分析。结果共纳入22篇文献,其中11个研究采用卫生体系角度,多数研究的成本类型为直接医疗成本。纳入研究质量评价总体符合率为42%~70%,存在模型设定不全、不确定性分析不全面,缺乏利益相关方参与等不足。研究结果显示免疫治疗药物(地塞米松、托珠单抗)、中和抗体药物(REGEN-COV抗体)、小分子药物(巴瑞替尼、奈玛特韦/利托那韦、莫奈匹韦、法匹拉韦)和他汀类药物治疗新冠患者具有成本-效果,但对瑞德西韦的经济性评价结果存在一定的差异。结论目前有关抗新型冠状病毒感染药物的经济学评价研究相对较少,但显示新冠防治的多数药物干预措施具有成本-效果。建议未来开展更多规范的、基于中国国情的新冠药物经济学评价研究。Objective To systematically review the economic evaluation research of anti-novel coronavirus infection drugs at home and abroad,so as to promote clinical rational drug use.Methods The PubMed,Cochrane Library,EMbase,Web of Science,INAHTA,SinoMed,WanFang Data,and CNKI databases were systematically searched from January 1,2020 to March 25,2023,to collect economic evaluation studies related to anti-novel coronavirus infection drugs.Results A total of 22 articles were included,among which 11 studies were conducted from the perspective of health system,and most of the studies performed cost estimation on direct medical costs.The overall compliance rate of the included studies ranged from 42%to 70%,with deficiencies in model setting,incomplete uncertainty analysis,and lack of stakeholder participation.The results showed that immunotherapy drugs(Dexamethasone,Tocilizumab),neutralizing antibody(REGEN-COV antibody),small molecule drugs(Baricitinib,Nirmatrelvir/Ritonavir,Molnupiravir,Favipiravir)and statin were cost-effective.There was some variation in the results of the economic evaluation of Remdesivir.Conclusion At present,there are few studies on the economic evaluation of drug interventions in COVID-19.Existing studies have pointed out that most drug interventions are cost-effective.It is suggested that more standardized pharmacoeconomic evaluation studies based on the actual situation of China epidemic should be carried out in the future.

关 键 词：新型冠状病毒感染 药物干预 经济学评价 

分 类 号：R956[医药卫生—药学]