英夫利昔单抗治疗溃疡性结肠炎的成本-效用分析
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篇名: 英夫利昔单抗治疗溃疡性结肠炎的成本-效用分析
TITLE: Cost-utility Analysis of Infliximab in the Treatment of Ulcerative Colitis
摘要: 目的:评价英夫利昔单抗治疗溃疡性结肠炎的经济性。方法:计算机检索中国知网、万方数据知识服务平台、维普期刊资源整合服务平台、PubMed、Embase和Cochrane图书馆等数据库,检索时限均为建库起至2019年10月16日。收集英夫利昔单抗(试验组)对比常规药物(对照组)治疗溃疡性结肠炎的随机对照试验,通过Meta分析比较两组患者的疗效和安全性;采用成本-效用分析法分析其经济性,并进行单因素敏感性分析和概率敏感性分析。结果:Meta分析结果显示,使用英夫利昔单抗治疗的双盲试验亚组患者的临床反应率[RR=1.97,95%CI(1.64,2.36),P<0.00001]和临床缓解率[RR=3.19,95%CI(1.83,5.57),P<0.0001]均显著高于接受常规治疗的对照组。两种方案的不良反应发生率比较差异无统计学意义[RR=0.76,95%CI(0.54,1.06),P=0.10]。试验组方案的增量成本-效用比为348243.88元/质量调整生命年(QALY),明显高于患者的意愿支付阈值(212676元);敏感性分析支持上述结果。结论:在当前我国医疗保障水平下,与常规疗法相比,英夫利昔单抗用于治疗溃疡性结肠炎患者的经济性欠佳。
ABSTRACT: OBJECTIVE:To evaluate the economics of infliximab in the treatment of ulcerative colitis. METHODS :Retrieved from CNKI ,Wanfang database ,VIP,PubMed,Embase database and Cochrane Library since Oct. 16th in 2019,randomized controlled trials (RCTs)about infliximab (trial group )vs. conventional drugs (control group )in the treatment of ulcerative colitis were collected ,and efficacy and safety of two groups were compared by Meta-analysis. The economics were analyzed by cost-utility analysis ,and single factor sensitivity analysis and probability sensitivity analysis were conducted. RESULTS :The results of Meta-analysis showed that clinical response rate [RR =1.97,95% CI (1.64,2.36),P<0.000 01] and clinical remission rate [RR =3.19,95%CI(1.83,5.57),P<0.000 1] in double blind trial subgroup of infliximab treatment were both significantly higher than than control group of conventional treatment. There was no statistical significance in the incidence of severe ADR between 2 groups [RR =0.76,95%CI(0.54,1.06),P=0.10]. The incremental cost-utility ratio of trial group was 348 243.88 yuan/quality-adjusted life-year (QALY),which was significantly higher than the patient ’s willingness to pay threshold (212 676 yuan).The sensitivity analysis supported above results. CONCLUSIONS :Under the current level of medical security in China , compared with conventional therapy ,infliximab is less economical for the treatment of ulcerative colitis.
期刊: 2020年第31卷第22期
作者: 陈文煦,晨迪,沈爱宗
AUTHORS: CHEN Wenxu ,CHEN Di,SHEN Aizong
关键字: 溃疡性结肠炎;英夫利昔单抗;Meta分析;成本-效用分析
KEYWORDS: Ulcerative colitis ;Infliximab;Meta-analysis;Cost-utility analysis
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