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抗癌药物的不良事件成本和成本效益分析:系统性审查
Mingye Zhao1,2, Taihang Shao3, Yue Yin1,2
1Department of Pharmacoeconomics, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China.
在抗癌药物成本效益分析 (CEA) 中,不良事件 (AE) 成本经常被低估,影响结论. 标准化AE成本量化对于精确的瘤学经济评估至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 在瘤学瘤学.
- 药物经济学 药物经济学
背景情况:
- 准确量化不良事件 (AE) 成本对于抗癌药物的成本效益分析 (CEA) 至关重要.
- 低估的AE成本可能会对CEA的结论产生重大影响,可能导致癌症护理资源分配不足.
研究的目的:
- 评估抗癌药物CEA中的AE成本量化是否反映了真正的成本.
- 为了确定是否用实际价值取代估计的AE成本会改变成本效益的结论.
主要方法:
- 在PubMed,Web of Science和Tufts CEA数据库 (2003-2023) 的系统文献搜索.
- 从CEA获得的AE成本与基于索赔的数据 (实际价值) 的比较.
- 分析AE成本调整对特定门上增量成本效益比率 (ICER) 的影响.
主要成果:
- CEA AE成本估计始终低于实际价值 (总医疗费用的中位数差异为9.73%和17,201美元绝对值).
- 调整AE成本使ICER变化为每QALY42,656美元,在47.1%的案例中改变了结论.
- 常见问题包括不完整的AE报告,专注于与治疗相关的与全因AE,以及排除较低级别的AE和后进展成本.
结论:
- 抗癌药物AE成本在CEA中经常被低估,可能会扭曲成本效益的发现.
- 不完整的AE纳入,不准确的成本估计和被忽视的长期影响是关键问题.
- 建议制定最佳实践和标准化指南,用于在瘤学中量化AE成本.
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