中国肝癌治疗卫生经济学研究的系统评价
1. 广西中医药大学, 财务处, 广西南宁 530222
2. 广西中医药大学, 赛恩斯新医药学院, 广西南宁 530222
3. 广西中医药大学, 基础医学院, 广西南宁 530222
| 摘 要： | 目的：系统评价中国人群肝癌治疗的卫生经济学研究现状。方法：以“中国”“肝癌”“治疗”“卫生经济学评价”为主题词，计算机检索CNKI、WanFang data、VIP、PubMed、EMbase、The Cochrane Library及Web of Science等数据库，搜集关于中国肝癌治疗的卫生经济学研究文献，检索时间段均为数据库建库至2022年10月1日。由2位研究者根据筛选条件独立筛选文献作为纳入研究；对各研究进行偏倚风险评价，对其研究对象、评价模型、评价方法、研究视角等进行定性分析；为便于比较，对医疗成本进行换算并以5%的贴现率统一贴现至2021年人民币水平；对于评价了增量成本效果比（ICER）的研究，进行进一步统计，分析其是否具有成本效果。结果：最终纳入28个研究，其中中文文献14篇，英文文献14篇；60.7%的研究对象为中晚期肝癌患者，32.1%为早中期肝癌患者，7.1%不限于分期，10.7%的研究对中医药方案进行了评价；92.9%的研究使用成本-效果分析评价，7.1%使用最小成本分析法；46.4%%（13/28）的研究使用了Markov模型，7.1%使用分区生存模型，46.4%%的研究未建立经济模型；报告了ICER的研究中，增量成本中位数为211611.07元，ICER中位数为554915.14元，质量调整生命年的中位数为0.875个QALY。结论：目前中国肝癌治疗以手术、介入、放化疗为主，还存在较少考虑间接医疗成本的局限，对中医方案进行评价可能是一个热点研究方向。 |
| 关 键 词： | 肝癌; 治疗; 卫生经济学; 系统评价 |
| DOI： | 10.57237/j.cmf.2023.04.001 |
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收稿日期: 2023-08-11
接受日期: 2023-10-07
在线出版日期: 2023-10-09
A Systematic Review of Health Economics Research on the Treatment of Liver Cancer in China
1. Finance Office, Guangxi University of Chinese Medicine, Nanning 530222, China
2. Department of Medicine, Faculty of Chinese Medicine Science, Guangxi University of Chinese Medicine, Nanning 530222, China
3. School of Basic Medicine, Guangxi University of Chinese Medicine, Nanning 530222, China
| Abstract: | Objective: To systematically evaluate the health economics research status of the treatment of liver cancer in Chinese groups. Methods: Taking "China", "liver cancer", "treatment" and "health economics evaluation" as the theme headings, the computer searched CNKI, WanFang data, VIP, PubMed, EMbase, The Cochrane Library and Web of Science to collect health economics research literature on the treatment of liver cancer in China, and the search period was all established until October 1, 2022. Two review authors independently selected studies for inclusion based on screening criteria; The risk of bias of each study was evaluated, and the research objects, evaluation models, evaluation methods, research perspectives, etc. were qualitatively analyzed; For comparison, medical costs are converted and discounted at a discount rate of 5% to the RMB level in 2021; For studies that evaluated the incremental cost-effectiveness ratio (ICER), further statistics were performed to analyze whether it had a cost effect. Results: A total of 28 studies were included, including 14 Chinese and 14 English studies. 60.7% of the study subjects were patients with intermediate and advanced liver cancer, 32.1% were patients with early and intermediate liver cancer, 7.1% were not limited to staging, and 10.7% of the studies evaluated the traditional Chinese medicine program. 92.9% of studies used cost-effect analysis and 7.1% used least-cost analysis; 46.4% (13/28) of studies used the Markov model, 7.1% used the partition survival model, and 46.4% did not establish an economic model; In the study reporting ICER, the median incremental cost was ¥211,611.07, the median ICER was ¥554,915.14, and the median quality-adjusted life years were 0.875 QALYs. Conclusion: At present, the treatment of liver cancer in China is mainly surgery, intervention, radiotherapy and chemotherapy, and there are still limitations of less consideration of indirect medical costs, and the evaluation of traditional Chinese medicine programs may be a hot research direction. |
| Keywords: | Liver Cancer; Treat; Health Economics; Systematic Reviews |
基金
| 1. | 广西中医药大学赛恩斯新医药学院创新团队项目 (编号: 2022CX004) |
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