晚期肝癌治疗药物的经济学文献研究

目的探讨晚期肝癌治疗药物的成本-效果,为临床合理用药提供参考。方法检索国内外关于治疗晚期肝癌的药物经济学文献,分析研究设计、模型建立及参数设置。结果共纳入文献18篇,大多数研究根据Ⅲ期临床试验的数据建立Markov模型,比较治疗方案间的增量-成本比和患者支付意愿阈值;多数研究结果显示,索拉非尼不具有成本-效果,肝癌二线治疗药物瑞戈非尼、卡博替尼、雷莫芦单抗也不具有成本-效果。结论研究结果受国家、人群的影响,但多数研究显示,晚期肝癌靶向治疗药物不具有成本-效果,可在我国开展真实世界的药物经济学评价进一步论证。

Pharmacoeconomics of Drugs for the Treatment of Advanced Hepatocellular Carcinoma:A Literature Review

Objective To investigate the cost-effectiveness of drugs for the treatment of advanced hepatocellular carcinoma and provide a reference for clinical rational medication.Methods The pharmacoeconomics literature about the treatment of advanced hepatocellular carcinoma at home and abroad were searched,and the research design,model establishment and parameter setting were analyzed.Results A total of 18 studies were included.Markov model was established for most of the researches based on the data of phaseⅢclinical trials to compare the incremental-cost ratio among the different treatment plans and the threshold of patients’willingness to pay(WTP).Most of the results showed that sorafenib had no cost-effectiveness,and the second-line treatment drugs of hepatocellular carcinoma,such as regorafenib,cabozantinib and ramucirumab,also had no cost-effectiveness.Conclusion The results of the studies are influenced by countries and the population,but most studies show that the targeted therapy drugs for advanced hepatocellular carcinoma have no cost-effectiveness,which can be further confirmed by the real-world pharmacoeconomic evaluation in China.