非小细胞肺癌一线免疫治疗的药物经济学研究综述  

Review of Research on Pharmacoeconomics of First-line Immunotherapy for Treating Non-small Cell Lung Cancer

作　　者：吴昌金 李汶檀 陶红宇 章溪妍 辛雨 宋若萌 王凯歌 左玲 蔡源益[1] 惠文 WU Changjin(School of Health Management,China Medical University,Shenyang,Liaoning,110122,China)

机构地区：[1]中国医科大学健康管理学院,辽宁沈阳110122 [2]中国医学科学院医药生物技术研究所,北京100050 [3]四川大学华西医院科技部,四川成都610041 [4]四川大学华西医院呼吸与危重症医学科,四川成都610041 [5]四川大学华西医院门诊部全程管理中心,四川成都610041

出　　处：《医学与社会》2023年第11期94-100,共7页Medicine and Society

基　　金：教育部人文社科基金,编号为22YJCZH065;四川省自然科学基金,编号为2023NSFSC1046;辽宁省教育厅人文社科课题,编号为QNRW2020007。

摘　　要：目的:系统评价国内外非小细胞肺癌一线免疫治疗的药物经济学研究,为研究人员开展相关药物经济学研究以及决策者利用相关研究证据提供参考。方法:检索PubMed、Embase、Cochrane、Health Technology Assessment Database、National Health Service Economic Evaluation Database、中国生物医学文献服务系统、中国知网、万方和维普等数据库,提取纳入研究的基本情况和药物经济学研究特征。使用卫生经济学研究质量评价量表对研究质量进行评价。结果:共纳入61篇文献,其中包括10篇中文文献和51篇英文文献。纳入文献的研究方案主要为免疫药物对比化疗方案,评价最多的药物为帕博利珠单抗(n=32,52.5%)。所有研究均为使用模型进行长期模拟的二次研究,模型以马尔科夫模型(n=39,63.9%)和分区生存模型(n=20,32.8%)为主。疗效数据均来自临床试验。卫生经济学研究质量评价量表得分为45-95分,平均74.3分,75-100分高质量文献共有28篇(45.9%)。中文文献研究质量总体低于英文文献。结论:国内外非小细胞肺癌一线免疫治疗的药物经济学研究均是基于长期模拟的模型研究,但研究质量仍有待提高。今后研究可在参数来源途径、模型结构及其验证以及研究角度与成本界定的一致性等方面加以改进。Objective:To systematically review the research on pharmacoeconomics of first-line immunotherapy for non-small cell lung cancer,so as to provide references for researchers to carry out relevant evaluations and policymakers to use relevant research evidence.Methods:PubMed,Embase,Cochrane,Health Technology Assessment Database,National Health Service Economic Evaluation Database,SinoMed,CNKI,Wanfang and VIP databases were searched to collect basic data and relevant information about the pharmacoeconomic evaluation.The quality assessment was performed by using the quality of health economic studies.Results:A total of 61 studies were included,including 10 Chinese articles and 51 English articles.The main therapy of included research was immune drugs alone versus chemotherapy regimens,and pembrolizumab was the most common drug in the economic evaluation(n=32,52.5%).All studies were secondary studies using models for long-term simulation,mainly by using the Markov model(n=39,63.9%)and partitioned survival model(n=20,32.8%).And the health outcomes were all sourced from randomized clinical trials.According to the assessment of quality of health economic studies,the scores ranged from 45 to 95 points,with an average of 74.3 points,and 28 high-quality studies(45.9%)scored 75 to 100 points.The overall qualities of Chinese studies were lower than that of English studies.Conclusion:Global pharmacoeconomic evaluations of first-line immunotherapy for non-small cell lung cancer utilize long-term simulation models.However,there is still room for improvement in research quality.Future studies need to be improved in terms of the source of parameters,model structure and validation,and the consistency of perspective and cost definition.

关 键 词：卫生技术评估 药物经济学 非小细胞肺癌 免疫治疗 

分 类 号：R195.4[医药卫生—卫生统计学]