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基于风险因素的肺癌查计划的成本效益分析低剂量计算机断层扫描在中国目前的吸烟者中

Tiantian Zhang^1,2, Xudong Chen¹, Caichen Li³

¹College of Pharmacy/Guangdong-Hong Kong-Marco Greater Bay Area (GBA), Institue for Real-World Value and Evidence of Drugs and Medical Devices/Southern Institute of Pharmacoeconomics and Health Technology Assessment/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug, Development of Ministry of Education (MOE) of China, Jinan University, Guangzhou 510632, China.

|September 28, 2023

概括

低剂量计算机断层扫描 (LDCT) 的肺癌查对中国高风险人群来说是具有成本效益的. 最佳的策略包括对年龄在55-79岁的个体进行年度查,其吸烟史超过20包年.

科学领域:

卫生经济学卫生经济学
公共卫生公共卫生
在瘤学瘤学.

背景情况:

肺癌仍然是全球癌症死亡的主要原因,需要有效的查策略.
低剂量计算机断层扫描 (LDCT) 已在肺癌查中表现出有效性,但其经济影响需要进一步调查,特别是在中国等不同地区.

研究的目的:

评估使用LDCT在中国的肺癌查的成本效益.
根据各种人口统计和生活方式因素,确定最佳查策略并定义高风险人群.

主要方法:

开发了马尔科夫模型来模拟肺癌的自然史和诊断后状态.
评估了36个不同的查策略,不同的开始和停止年龄,以及吸烟资格标准.
利用来自中国广州社区LDCT查的数据.

主要成果:

与没有查相比,所有评估的LDCT查场景都显示增加成本和质量调整寿命年 (QALYs).
对于年龄在55-79岁,吸烟史超过20包年的人,每年查被认为是最佳的,每QALY获得的增量成本效益比 (ICER) 约为35,000美元.
观察到最佳查策略的区域差异,与当地支付意愿门和经济条件保持一致.

结论:

低发达国家肺癌查可以成为中国特定高风险人群的经济有效干预措施.
建议制定针对特定区域的查政策,以最大限度地提高经济效率和公共卫生影响.
进一步的研究可能会根据不断变化的流行病学数据和经济景观来改进查参数.

关键词:

中国中国中国中国.LDCT的选对象包括:分析成本效益分析.现在的吸烟者.肺癌是一种肺癌.

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