伊马替尼治疗慢性粒细胞白血病的药物经济学定性系统评价

摘要

目的 对伊马替尼治疗慢性粒细胞白血病(CML)的药物经济学定性系统进行评价.方法 经数据库检索伊马替尼治疗CML经济性文献.药品名称检索关键词为格列卫/伊马替尼(glivec/imatinib),疾病名称检索关键词为慢性粒细胞白血病/白血病(CML/Leukemia);经济学研究检索关键词包括Cost、Cost benefit analysis、Eco-nomic evaluation、Cost effectiveness analysis和Cost utility analysis,中文检索关键词包括成本、成本效果研究、成本效益研究、成本效用研究和经济学评价.结果 筛选出7篇文献:5篇成本分析和2篇系统综述文献.5篇论著基于临床试验数据,并采用QALY值利于各个文献间的比较;2篇系统综述均设定严格的排除入选标准后,进行文献荟萃分析.本研究入选文献显示,伊马替尼与干扰素、骨髓移植比较时,增量成本效用比较低;伊马替尼与羟基脲比较时增量成本效用比较高.结论 相对于干扰素、骨髓移植等传统治疗方式,伊马替尼具有较好的成本效果优势;与羟基脲相比,伊马替尼并不具有成本效果优势.%Objective To qualitatively and systematically evaluate the pharmacoeconomics of imatinib in the treatment of chronic myelogenous leukemia (CML).Methods Literature search was conducted using different databases.The search keywords were glivec/imatinib for drug name,and CML/leukemia for disease name.Economic research keywords included cost,cost-bene-fit analysis,economic evaluation,cost-effectiveness analysis and cost-utility analysis.Chinese search keywords included cost,cost-effectiveness analysis,cost-benefit analysis,cost-utility analy-sis and economic evaluation.Results Seven publications were retained,including 5 cost analyses and 2 systematic reviews.Five of them were based on clinical trial data,and QALY values were used to compare the literatures.Strict exclusion criteria were used and meta-analysis was per-formed in the 2 systematic reviews.These literatures showed that the incremental cost-effective-ness ratio of imatinib decreased when compared to traditional treatment with interferon (IFN) and allogeneic hematopoietic stem cell transplantation (allo-HSCT),but increased when compared to hydroxyurea.Conclusion Imatinib treatment has a higher cost-effectiveness ratio than tradi-tional therapy such as IFN and allo-HSCT.However,hydroxyurea is more cost-effective than ima-tinib.