Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary,
Eur J Health Econ. 2014 May;15 Suppl 1:S27-34. doi: 10.1007/s10198-014-0591-7. Epub 2014 May 16.
Several Central and Eastern European (CEE) countries require cost-utility analyses (CUAs) to support reimbursement formulary listing. However, CUAs informed by local evidence are often unavailable, and the cost-effectiveness of the several currently reimbursed biologicals is unclear.
To estimate the cost-effectiveness as multiples of per capita GDP/quality adjusted life years (QALY) of four biologicals (infliximab, etanercept, adalimumab, golimumab) currently reimbursed in six CEE countries in six inflammatory rheumatoid and bowel disease conditions.
Systematic literature review of published cost-utility analyses in the selected conditions, using the United Kingdom (UK) as reference country and with study selection criteria set to optimize the transfer of results to the CEEs. Prices in each CEE country were pro-rated against UK prices using purchasing power parity (PPP)-adjusted per capita GDP, and local GDP per capita/QALY ratios estimated.
Central and Eastern European countries list prices were 144-333% higher than pro rata prices. Out of 85 CUAs identified by previous systematic literature reviews, 15 were selected as a convenience sample for estimating the cost-effectiveness of biologicals in the CEE countries in terms of per capita GDP/QALY. Per capita GDP/QALY values varied from 0.42 to 6.4 across countries and conditions (Bulgaria: 0.97-6.38; Czech Republic: 0.42-2.76; Hungary: 0.54-3.54; Poland: 0.59-3.90; Romania: 0.77-5.07; Slovakia: 0.55-3.61).
While results must be interpreted with caution, calculating pro rata (cost-effective) prices and per capita GDP/QALY ratios based on CUAs can aid reimbursement decision-making in the absence of analyses using local data.
一些中东欧（CEE）国家要求进行成本效用分析（CUA）以支持报销目录的编制。然而，基于当地证据的 CUA 往往不可用，并且目前报销的几种生物制剂的成本效益尚不清楚。
评估四种生物制剂（英夫利昔单抗、依那西普、阿达木单抗、戈利木单抗）在六个 CEE 国家的六种炎症性类风湿和肠道疾病情况下的成本效益，以人均 GDP/质量调整生命年（QALY）的倍数表示。
对选定条件下已发表的成本效用分析进行系统文献回顾，以英国（UK）作为参考国，并设定研究选择标准，以最大限度地将结果转移到 CEE 国家。使用购买力平价（PPP）调整后的人均 GDP 将每个 CEE 国家的价格按比例分摊到英国价格，并估算当地人均 GDP/QALY 比率。
CEE 国家的列表价格比按比例分摊的价格高出 144-333%。通过先前的系统文献回顾确定了 85 项 CUA，从中选择了 15 项作为便利样本，以根据人均 GDP/QALY 评估 CEE 国家中生物制剂的成本效益。各国和各条件下的人均 GDP/QALY 值有所不同（保加利亚：0.97-6.38；捷克共和国：0.42-2.76；匈牙利：0.54-3.54；波兰：0.59-3.90；罗马尼亚：0.77-5.07；斯洛伐克：0.55-3.61）。
虽然结果必须谨慎解释，但在缺乏使用当地数据进行分析的情况下，基于 CUA 计算按比例分摊（具有成本效益）的价格和人均 GDP/QALY 比率可以辅助报销决策。
