布地奈德/福莫特罗对比氟替卡松/沙美特罗治疗哮喘的药物经济学的系统评价

摘要

OBJECTIVE:To review economics of budesonide/formoterol and fluticasone/salmeterol for asthma systematically, and to provide evidence-based basis for rational selection of drug to treat asthma. METHODS:Retrieved from Medline,EMBase, EBM reviews (HTA,NHSEED),CBM,CJFD,Wanfang database,researches about pharmacoeconomics of budesonide/formoterol (test group) versus fluticasone/salmeterol (control group)for asthma were collected,and analyzed with qualitative systematic re-view method. RESULTS:A total of 7 researches and 13 comparative data were included,containing 6 682 patients. The incidence of severe acute asthma of test group were lower than those of control group,with significant difference(P<0.05). The total costs and direct costs of test group were lower than those of control group. Good effect had been achieved in test group with low cost. CONCLUSIONS:Budesonide/formoterol is more cost-effective than fluticasone/salmeterol in teenagers patients and adults who fail to control asthma. Due to limitation of included studies,large-scale and high-quality studies are required for further validation of the conclusion.%目的：系统评价布地奈德/福莫特罗对比氟替卡松/沙美特罗治疗哮喘的经济性，为临床合理选择治疗哮喘药物提供循证依据。方法：检索Medline、EMBase、EBM Reviews（HTA、NHSEED）、中国生物医学文献数据库、中国期刊全文数据库、万方数据库，收集布地奈德/福莫特罗（试验组）对比氟替卡松/沙美特罗（对照组）治疗哮喘的药物经济学研究，采用定性的系统评价方法进行分析。结果：共纳入7项研究13项数据，合计6682例患者。结果表明，试验组患者哮喘严重急性发作率显著低于对照组，两组比较差异有统计学意义（P＜0.05）。成本方面，试验组患者的总成本较对照组低，直接成本不高于对照组。试验组以较低成本取得了较高的效果。结论：在未能有效控制的青少年及成人哮喘患者中采用布地奈德/福莫特罗治疗较氟替卡松/沙美特罗更具有成本-效果优势。由于纳入研究的局限性，该结论有待大样本、高质量的研究进一步证实。