固定三联吸入制剂治疗中重度慢性阻塞性肺疾病药物经济学系统评价  

Pharmacoeconomic Systematic Review of Fixed Triple Inhalation Therapy for Moderate-to-Severe Chronic Obstructive Pulmonary Disease

作　　者：丁雪茹[1] 李鹏[1] 刘慧敏[1] 柯昌虎[1] 李华[1] 李志浩[1] DING Xueru;LI Peng;LIU Huimin;KE Changhu;LI Hua;LI Zhihao(Guoyao Dongfeng General Hospital Affiliated to Hubei University of Medicine,Shiyan,Hubei,China 442000)

机构地区：[1]湖北医药学院附属国药东风总医院,湖北十堰442000

出　　处：《中国药业》2025年第6期103-109,共7页China Pharmaceuticals

基　　金：湖北省十堰市科技局引导性科研项目[22Y75];湖北陈孝平科技发展基金会青年科学专项基金[CXPJJH123001-2310]。

摘　　要：目的系统评价固定三联吸入制剂治疗急性加重风险性慢性阻塞性肺疾病(COPD)的药物经济学价值。方法检索中国知网、万方、维普网、PubMed、Embase、The Cochrane Library、Web of Science、ScienceDirect等数据库,检索时限为各数据库自建库起至2023年12月15日,收集固定三联吸入制剂治疗COPD的药物经济学研究。结果共纳入13篇文献,使用CHEERS 2022量表评价的文献质量均为高质量,其中6篇为GALAXY COPD模型、3篇为Markov模型、2篇为semi-Markov模型、2篇为决策树模型和Markov模型相结合。文献研究结果显示,固定三联吸入制剂较单药制剂、双联制剂、多吸入器三联制剂更具成本-效果,其中智利的1项研究表明,固定三联制剂氟替美维降价10%可具有经济学优势。结论纳入研究受不同国家卫生体系、医疗保障制度及国情限制,不能完全反映我国的实际情况,亟需更多高质量的国内药物经济学研究,为我国COPD临床用药提供参考。Objective To systematically evaluate the pharmacoeconomic value of fixed triple inhalation therapy for moderate-to-severe chronic obstructive pulmonary disease(COPD).Methods Databases including CNKI,Wanfang,VIP,PubMed,Embase,The Cochrane Library,Web of Science,and ScienceDirect were searched from inception to December 15,2023,to collect pharmacoeconomic studies on fixed triple inhalation therapy for COPD.Results A total of 13 studies were included,all of which were of high quality according to the CHEERS 2022 checklist.Among them,six studies used the GALAXY COPD model,three used the Markov model,two used the semi-Markov model,and two used a combination of the decision tree model and the Markov model.The results indicated that fixed triple inhalation therapy was more cost-effective than monotherapy,dual therapy,and multiple-inhaler triple therapy.One study from Chile suggested that a 10%price reduction for the fixed triple inhalation therapy of fluticasone,tiotropium,and vilanterol could provide an economic advantage.Conclusion The included studies were influenced by different national healthcare systems,medical insurance policies,and local contexts,making them insufficient to fully reflect the situation in China.More high-quality domestic pharmacoeconomic research is urgently needed to provide references for clinical medication in COPD treatment in China.

关 键 词：三联吸入制剂 慢性阻塞性肺疾病 急性加重 药物经济学 系统评价 

分 类 号：R969.3[医药卫生—药理学]