Adelaide Medical School, Faculty of Health Sciences, The University of Adelaide, SAHMRI, South Australia, Australia.
Institute for Choice, University of South Australia, Adelaide, South Australia, Australia.
Value Health. 2019 Feb;22(2):254-262. doi: 10.1016/j.jval.2018.07.878. Epub 2018 Aug 31.
To examine economic evaluation studies of stem cell therapies (SCTs) in neurological disorders and to provide an overview of the quality of the economic evidence available on this topic.
The review examined studies that performed an economic evaluation of the use of stem cells in adult patients with neurological diseases and that were published in English during the period 2007 to 2017. Data analyzed and reported included study population, disease indication, main analytical approaches for the economic analysis and perspective, key assumptions made or tested in sensitivity analyses, cost outcomes, estimates of incremental cost effectiveness, and approaches to quantifying decision uncertainty.
A total of three studies reporting on the findings of the economic evaluation of the use of SCT in stroke, Parkinson disease, and secondary progressive multiple sclerosis, respectively, were identified. All three studies conducted a cost-utility analysis using decision-analytic models and reported an incremental cost per quality-adjusted life-years gained (incremental cost-effectiveness ratio) versus standard care. These studies reported meaningful cost savings in stroke, Parkinson disease, and secondary progressive multiple sclerosis in the base-case scenarios.
Despite significant progress in clinical research in the use of SCT in neurological diseases, economic evaluation of these therapies is still at a nascent stage. Given the early stage of research inputs (clinical and cost outcomes data) into the models per se, further research is urgently needed to enable meaningful assessment of the cost effectiveness of these advanced therapies and to ensure sustainable access for population groups most likely to benefit in clinical practice.
考察神经疾病干细胞治疗(SCT)的经济评价研究,并对该主题现有经济证据的质量进行概述。
本综述考察了 2007 年至 2017 年间以成年神经疾病患者使用干细胞为研究对象,并以英文发表的经济评价研究。分析和报告的数据包括研究人群、疾病指征、经济分析的主要分析方法和视角、敏感性分析中做出或测试的主要假设、成本结果、增量成本效益估计,以及量化决策不确定性的方法。
共确定了三项分别报告 SCT 在中风、帕金森病和继发进展性多发性硬化中使用的经济评价结果的研究。这三项研究均使用决策分析模型进行成本效益分析,并报告了与标准护理相比的每获得一个质量调整生命年的增量成本(增量成本效益比)。这些研究在基线情况下报告了中风、帕金森病和继发进展性多发性硬化中的显著成本节约。
尽管在神经疾病中使用 SCT 的临床研究取得了重大进展,但这些疗法的经济评价仍处于起步阶段。鉴于模型本身的研究投入(临床和成本结果数据)处于早期阶段,迫切需要进一步研究,以对这些先进疗法的成本效益进行有意义的评估,并确保在临床实践中最有可能受益的人群能够可持续获得这些疗法。