Cost-effectiveness of multiple sclerosis disease-modifying therapies: a systematic review of the literature.
Cost-effectiveness of multiple sclerosis disease-modifying therapies: a systematic review of the literature.
复制标题
多发性硬化症疾病缓解疗法的成本效益：文献的系统回顾。
DOI：
10.1155/2012/784364
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发表时间：
2012
影响因子：
4
通讯作者：
Campbell,JonathanD
中科院分区：
文献类型：
--
作者：
Yamamoto,David;Campbell,JonathanD
目标。通过定量评估最近成本效益研究的质量和探索该领域如何从过去的建议中取得进展，提供对dmt治疗多发性硬化症的成本效益的当前和全面理解。我们使用健康经济研究质量验证工具评估了符合系统文献检索标准的研究质量。在符合我们最初搜索标准的82项研究中，我们在本综述中纳入了22项。4项研究（18%）达到了质量类别2,3项研究（14%）达到了质量类别3,15项研究（68%）达到了最高质量类别4。91%的研究是模拟模型。13项研究（59%）以质量调整生命年（QALYs）作为主要结局指标，在分析中纳入社会视角，并利用10年至一生的时间范围。为了继续改善dmt的成本效益证据，我们建议：终身视野、社会视角和质量评估；补充证据，提供更短的时间跨度、支付方视角和临床结果，为多个决策者提供信息；制定模型和输入标准以实现可比性；dmt与长期前瞻性研究之间的头对头随机对照试验；以及比较所有合适的dmt的综合成本效益研究。
Objective. To provide a current and comprehensive understanding of the cost‐effectiveness of DMTs for the treatment of MS by quantitatively evaluating the quality of recent cost‐effectiveness studies and exploring how the field has progressed from past recommendations.Methods. We assessed the quality of studies that met our systematic literature search criteria using the Quality of Health Economic Studies validated instrument.Results. Of the 82 studies that met our initial search criteria, we included 22 in this review. Four studies (18%) achieved quality category 2, three studies (14%) achieved quality category 3, and 15 studies (68%) achieved the highest quality category 4. 91% of studies were simulation models. 13 studies (59%) had quality‐adjusted life years (QALYs) as the primary outcome measure, included a societal perspective in the analysis, and utilized time horizons of 10 years to lifetime.Conclusions. To continue to improve the cost‐effectiveness evidence of DMTs, we recommend: lifetime horizons, societal perspectives, and QALYs; supplemental evidence with shorter horizons, payer perspectives, and clinical outcomes to inform multiple decision makers; development of modeling and input standards for comparability; head‐to‐head RCTs between DMTs and long‐term prospective studies; and comprehensive cost‐effectiveness studies that compare all appropriate DMTs.