Universitat Pompeu Fabra, Balmes 132, 08008 Barcelona, Spain.
Expert Rev Pharmacoecon Outcomes Res. 2007 Dec;7(6):613-26. doi: 10.1586/14737167.7.6.613.
Clinical trials and economic models have showed that anti-TNF agents are effective and cost effective compared with standard therapies (mainly disease-modifying antirheumatic drugs) in patients with rheumatoid arthritis. However, no head-to-head clinical trials between these agents are available and the relative effectiveness and cost-effectiveness is uncertain. We have conducted a literature review in order to identify full economic evaluations that compared two or more TNF antagonists. A description of each study was given and key methodological issues identified. These included methods for evidence synthesis, model characteristics and methods to address uncertainty in model parameters. Important differences in methodological features and results have been found between studies. More attention in future studies should be given to methods for indirect comparisons between the biological agents.
临床试验和经济模型表明，与标准治疗（主要是疾病修饰抗风湿药物）相比，抗 TNF 药物在类风湿关节炎患者中具有有效性和成本效益。然而，目前尚无这些药物之间的头对头临床试验，其相对有效性和成本效益尚不确定。我们进行了文献回顾，以确定比较两种或多种 TNF 拮抗剂的全经济评估。对每项研究进行了描述，并确定了关键的方法学问题。这些问题包括证据综合方法、模型特征以及解决模型参数不确定性的方法。研究之间发现了方法学特征和结果的重要差异。未来的研究应更加关注生物制剂之间间接比较的方法。
