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间变性淋巴瘤激酶阳性非小细胞肺癌治疗药物经济性的系统评价
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| 篇名： | 间变性淋巴瘤激酶阳性非小细胞肺癌治疗药物经济性的系统评价 |
| TITLE： | Systematic review of the economical efficiency of drugs for anapastic lymphoma kinase-positive non-small cell lung cancer |
| 摘要： | 目的 系统评价我国已上市的间变性淋巴瘤激酶（ALK）-酪氨酸激酶抑制剂（TKI）治疗ALK阳性非小细胞肺癌（NSCLC）的经济性，为我国医保目录遴选和药品定价提供参考。方法计算机检索中国知网、万方数据知识服务平台、维普数据库、PubMed、Embase、TheCochraneLibrary等数据库，收集我国已上市的4个ALK-TKI（克唑替尼、塞瑞替尼、阿来替尼和恩沙替尼）治疗ALK阳性NSCLC的药物经济学评价研究，检索时限为从建库至2021年7月。利用卫生经济学评价报告标准共识（CHEERS）清单对纳入文献进行质量评价，从方法学和经济性结果2个方面对纳入研究进行系统分析。结果最终纳入6篇文献，CHEERS清单标准符合率为71％～83％，文献总体质量较高。从方法学分析，纳入研究的药物经济学评价方法主要为基于模型（Markov模型或分区生存模型）和真实世界数据的成本-效用分析；研究角度大多为医保支付方和卫生体系角度；成本类型均为直接医疗成本。从经济性结果分析，在与化疗方案对比时，2项研究证实ALK-TKI（克唑替尼、塞瑞替尼）不具有经济性，1项研究证实ALK-TKI（克唑替尼）具有经济性；在与其他ALK-TKI对比时，塞瑞替尼的经济性相对较高。药价过高是ALK-TKI治疗ALK阳性NSCLC不具有经济性的主要因素。结论第二代ALK-TKI（塞瑞替尼、阿来替尼）的经济性要优于第一代ALK-TKI（克唑替尼）；第二代ALK-TKI药物之间，塞瑞替尼的经济性更好；化疗方案的经济性要优于第二代ALK-TKI（塞瑞替尼）；化疗方案与第一代ALK-TKI（克唑替尼）之间的经济性对比结果仍存在争议。 |
| ABSTRACT： | OBJECTIVE To systematically evaluate the economical efficiency of marketed a naplastic lymphoma kinase （ALK）-tyrosine kinase inhibitors （TKI）for the treatment of ALK-positive non-small cell lung cancer （NSCLC）in China ，and to provide a reference for the selection of China ’s medical insurance list and drug pricing. METHODS Computer searches of databases such as CNKI ，Wanfang database ，VIP，PubMed，Embase and the Cochrane Library were conducted to collect pharmacoeconomic evaluation studies of four marketed ALK-TKI （crizotinib，seretinib，aletinib and ensatinib ）in the treatment of ALK-positive NSCLC in China during the inception to July 2021. The qualities of the included literature were evaluated using CHEERS checklist ，and analyzed systematically in terms of both methodological and economic outcomes. RESULTS A total of 6 literatures were included ，with a compliance rate of 71％ to 83％ for the CHEERS list criteria ，and the overall quality of the literature was high. In terms of methodological analysis ，the pharmacoeconomic evaluation methods included in the study were mainly model-based （Markov or partitioned survival models ） and real-world data-based cost-utility analysis. Most research perspectives were health insurance payer and health system perspectives ；all cost types were direct medical costs. In terms of economical efficiency analysis ，compared with chemotherapy plan ，2 studies confirmed that ALK-TKI （crizotinib，seretinib）were not economic ，1 study confirmed ALK-TKI （crizotinib） showed economical efficiency. Seretinib showed relatively higher economical efficiency when compared to other ALK-TKIs. High drug prices were the main factor why ALK-TKI was not economically viable for treating ALK-positive NSCLC. CONCLUSIONS The second-generation ALK-TKI （seretinib， 163.com alectinib） have better economical efficiency than the first-generation ALK-TKI （crizotinib）. The economical efficiency of seretinib is the best among the second-generation · ALK-TKI. The economical efficiency of chemotherapy regimen is better than that of the second-generation ALK-TKI （seretinib）. Economic comparison between chemotherapy and first-generation ALK-TKI （crizotinib）remains controversial. |
| 期刊： | 2022年第33卷第11期 |
| 作者： | 齐冉，高胜男，刘旭婷，刘洋，刘国强 |
| AUTHORS： | QI Ran，GAO Shengnan ，LIU Xuting ，LIU Yang，LIU Guoqiang |
| 关键字： | 间变性淋巴瘤激酶；酪氨酸激酶抑制剂；非小细胞肺癌；药物经济学；系统评价 |
| KEYWORDS： | anapastic lymphoma kinase ；tyrosine kinase inhibitors ；non-small cell lung cancer ；pharmacoeconomic；systematic |
| 阅读数： | 133 次 |
| 本月下载数： | 8 次 |
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