Al Kadour Ahmad, Marridi Wafa Al, Al-Badriyeh Daoud
College of Pharmacy, Qatar University, Doha, Qatar.
College of Pharmacy, Qatar University, Doha, Qatar; Pharmacy Department, Sidra Medical and Research Centre, Doha, Qatar.
Value Health Reg Issues. 2018 Sep;16:46-60. doi: 10.1016/j.vhri.2018.05.003. Epub 2018 Aug 22.
To review literature characteristics, describe methodological trends, and assess the reporting quality of the economic evaluations of oral anticancer drugs (OACDs).
The review included comparative economic evaluations of OACDs. The search was conducted via PubMed, Embase, EconLit, and Economic Evaluation Database, and studies till December 2017 were included. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, literature inclusion and data extraction were performed in duplicate by separate investigators. Outcome measures were literature characteristics, gaps and methodological trends, and reporting quality using the Consolidated Health Economic Evaluation Reporting Standards checklist. Data were summarized on the basis of methodological themes of interest. Descriptive statistics and tabulations were used for result presentation.
Out of 241 found articles, 21 were included. There is a recent increasing interest in the economics of OACDs, whereby the cost per quality-adjusted life-year, via cost-utility analysis, is the most used for decision making. Most of the studies were from the payer perspective, and the primary sources of data were clinical trials, expert panels, and medical charts. The dominance status (higher effect, lower cost) was a commonly reported outcome. Decision-analytic modeling was used in most of the studies, mostly including Markov modeling. Studies were highly heterogeneous in methodological aspects, and the included studies did not meet most of the reporting quality criteria.
High heterogeneity in methods in studies may limit the robustness and transferability of results, potentially misleading decision makers toward wrong decisions on OACDs. The transferability and generalizability of results are further limited by a "less than ideal" adherence to current reporting standards.
回顾文献特征，描述方法学趋势，并评估口服抗癌药物（OACD）经济评估的报告质量。
该综述纳入了OACD的比较经济评估。通过PubMed、Embase、EconLit和经济评估数据库进行检索，纳入截至2017年12月的研究。使用系统评价和Meta分析的首选报告项目清单，由不同的研究人员独立进行文献纳入和数据提取的重复操作。结局指标包括文献特征、差距和方法学趋势，以及使用综合健康经济评估报告标准清单评估报告质量。根据感兴趣的方法学主题对数据进行总结。采用描述性统计和列表呈现结果。
在检索到的241篇文章中，纳入了21篇。近期对OACD经济学的关注度不断提高，通过成本效用分析得出的每质量调整生命年成本是决策中最常用的指标。大多数研究从支付方角度进行，数据的主要来源是临床试验、专家小组和医疗记录。优势状态（效果更好，成本更低）是常见的报告结果。大多数研究使用了决策分析模型，主要包括马尔可夫模型。研究在方法学方面高度异质性，纳入的研究大多未达到报告质量标准。
研究方法的高度异质性可能会限制结果的稳健性和可转移性，可能会误导决策者在OACD上做出错误决策。结果的可转移性和普遍性进一步受到对当前报告标准“不太理想”的遵循情况的限制。
