作为目的地治疗的左心室辅助器件 (LVAD) 的成本效益:系统性审查
Tuba Saygın Avşar1, Louise Jackson2, Pelham Barton2
1Department of Applied Health Research, University College London, London, UK. t.avsar@ucl.ac.uk.
PharmacoEconomics - open
|February 20, 2025
概括
用于目的治疗的左心室辅助器件 (LVAD) 的经济评估显示质量中等. 大多数研究发现,与医疗管理相比,LVADs的成本效益不高,这凸显了需要更强大的研究的需要.
科学领域:
- 心血管医学 心血管医学
- 卫生经济学 卫生经济学
- 医疗技术评估 医疗技术评估
背景情况:
- 左心室辅助器件 (LVAD) 为晚期心力衰竭患者提供寿命延长和改善生活质量.
- 使用LVAD的目的地治疗是不符合心脏移植资格的患者的选择.
- 关于LVAD与最佳医疗管理的成本效益的高质量证据对于政策决策至关重要.
研究的目的:
- 确定和评估用于目的地治疗的LVAD经济评估的方法质量.
- 综合有关LVAD与最佳医疗管理相比的成本效益的研究结果.
主要方法:
- 系统审查遵循审查和传播中心的指导方针和PRISMA标准.
- 在六个数据库中搜索到2024年10月之前发表的经济评估.
- 独立的研究选择,数据提取和质量评估由两位审查员进行.
主要成果:
- 确定了14项经济评估,主要是模拟美国和英国的研究.
- 模型结构,方法和成本估计存在实质性的差异;有限的生命周期和资源使用数据不足是常见的.
- 总体而言,研究质量中等,包括遗漏的并发症,成本和不确定性在内的局限性;大多数研究发现LVADs除了两项英国评估外,不具有成本效益.
结论:
- 目前关于用于目的地治疗的LVADs的经济证据存在重大局限性.
- 需要更全面和更强大的经济评估,以告知针对目的地治疗的LVADs的政策.
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