大麻素治疗儿童耐药性癫痫的成本效益：系统评价经济评估的方案。
Cost-effectiveness of cannabinoids for pediatric drug-resistant epilepsy: protocol for a systematic review of economic evaluations.
机构信息
School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, K1G 5Z3, Canada.
Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y4W7, Canada.
出版信息
Syst Rev. 2019 Mar 27;8(1):75. doi: 10.1186/s13643-019-0990-z.
BACKGROUND
Drug-resistant epilepsy negatively impacts the quality of life and is associated with increased morbidity and mortality and high costs to the healthcare system. Cannabis-based treatments may be effective in reducing seizures in this population, but whether they are cost-effective is unclear. In this systematic review, we will search for cost-effectiveness analyses involving the treatment of pediatric drug-resistant epilepsy with cannabis-based products to inform decision-making by public healthcare payers about reimbursement of such products. We will also search for cost-effectiveness analyses of other pharmacologic treatments for pediatric drug-resistant epilepsy, as well as estimates of healthcare resource use, costs, and utilities, for use in a subsequent cost-utility analysis to address this decision problem.
METHODS
We will search the published and gray literature for economic evaluations of cannabis-based products and other pharmacologic treatments for pediatric drug-resistant epilepsy, as well as resource utilization and utility studies. Two independent reviewers will screen the title and abstract of each identified record and the full-text version of any study deemed potentially relevant. Study and population characteristics, the incremental cost-effectiveness ratio (ICER), as well as total costs and benefits, will be extracted, and quality will be assessed by use of the Drummond and CHEERS checklists; context-specific issues will also be considered. From model-based cost-utility and cost-effectiveness analyses, we will extract and summarize the model structure, including health states, time horizon, and cycle length. From resource utilization studies, we will extract data about the frequency of resource use (e.g., neurology visits, emergency department visits, admissions to hospital). From utility studies, we will extract the utility for each health state, the source of the preferences (e.g., child, parent, patient, general public), and the method of elicitation.
DISCUSSION
Drug-resistant epilepsy in children is associated with important costs to the healthcare system, and decision-makers require high-quality evidence on which to base reimbursement decisions. The results of this review will be useful to both decision-makers considering the decision problem of whether to reimburse cannabis-based products through public formularies and to analysts conducting studies in this area.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO no.: CRD42018099591 .
背景
耐药性癫痫会降低生活质量，增加发病率和死亡率，给医疗保健系统带来高昂的成本。基于大麻的治疗方法可能对减少该人群的癫痫发作有效，但它们是否具有成本效益尚不清楚。在本次系统评价中，我们将搜索涉及使用大麻制品治疗儿科耐药性癫痫的成本效益分析，为公共医疗保健支付者对这些产品的报销做出决策提供信息。我们还将搜索其他用于治疗儿科耐药性癫痫的药物治疗的成本效益分析，以及医疗资源使用、成本和效用的估计值，以用于后续的成本效用分析来解决这个决策问题。
方法
我们将在已发表和灰色文献中搜索关于大麻制品和其他用于治疗儿科耐药性癫痫的药物治疗的经济评估，以及资源利用和效用研究。两名独立的审查员将筛选每个已确定记录的标题和摘要，以及任何被认为潜在相关的研究的全文版本。将提取研究和人群特征、增量成本效益比 (ICER) 以及总成本和收益，并使用 Drummond 和 CHEERS 清单进行质量评估；还将考虑特定于背景的问题。从基于模型的成本效用和成本效益分析中，我们将提取并总结模型结构，包括健康状态、时间范围和周期长度。从资源利用研究中，我们将提取关于资源使用频率的数据（例如，神经病学就诊、急诊就诊、住院）。从效用研究中，我们将提取每个健康状态的效用、偏好的来源（例如，儿童、父母、患者、普通公众）以及偏好的 elicitation 方法。
讨论
儿童耐药性癫痫会给医疗保健系统带来重要成本，决策者需要高质量的证据来为报销决策提供依据。本综述的结果将对决策者考虑是否通过公共处方报销大麻制品的决策问题以及在该领域开展研究的分析师都非常有用。
系统评价注册
PROSPERO 编号：CRD42018099591。
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