Hashempour Reza, Raei Behzad, Safaei Lari Majid, Abolhasanbeigi Gallezan Nasrin, AkbariSari Ali
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, 0000-0002-2043-8451, Tehran, Iran.
Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Cost Eff Resour Alloc. 2021 Jan 13;19(1):3. doi: 10.1186/s12962-020-00256-2.
The limited health care resources cannot meet all the demands of the society. Thus, decision makers have to choose feasible interventions and reject the others. We aimed to collect and summarize the results of all cost utility analysis studies that were conducted in Iran and develop a Quality Adjusted Life Year (QALY) league table.
A systematic mapping review was conducted to identify all cost utility analysis studies done in Iran and then map them in a table. PubMed, Embase, Cochrane library, Web of Science, as well as Iranian databases like Iran Medex, SID, Magiran, and Barakat Knowledge Network System were all searched for articles published from the inception of the databases to January 2020. Additionally, Cost per QALY or Incremental Cost Utility Ratio (ICUR) were collected from all studies. The Joanna Briggs checklist was used to assess quality appraisal.
In total, 51 cost-utility studies were included in the final analysis, out of which 14 studies were on cancer, six studies on coronary heart diseases. Two studies, each on hemophilia, multiple sclerosis and rheumatoid arthritis. The rest were on various other diseases. Markov model was the commonest one which has been applied to in 45% of the reviewed studies. Discount rates ranged from zero to 7.2%. The cost per QALY ranged from $ 0.144 in radiography costs for patients with some orthopedic problems to $ 4,551,521 for immune tolerance induction (ITI) therapy in hemophilia patients. High heterogeneity was revealed; therefore, it would be biased to rank interventions based on reported cost per QALY or ICUR.
However, it is instructive and informative to collect all economic evaluation studies and summarize them in a table. The information on the table would in turn be used to redirect resources for efficient allocation. in general, it was revealed that preventive programs are cost effective interventions from different perspectives in Iran.
有限的医疗保健资源无法满足社会的所有需求。因此，决策者必须选择可行的干预措施并拒绝其他措施。我们旨在收集和总结在伊朗进行的所有成本效用分析研究的结果，并编制一份质量调整生命年（QALY）排行榜。
进行了一项系统的映射综述，以识别在伊朗进行的所有成本效用分析研究，然后将它们列入表格。检索了PubMed、Embase、Cochrane图书馆、科学网，以及伊朗的数据库如Iran Medex、SID、Magiran和巴拉卡特知识网络系统，以查找从数据库建立到2020年1月发表的文章。此外，从所有研究中收集了每QALY成本或增量成本效用比（ICUR）。使用乔安娜·布里格斯检查表来评估质量评估。
最终分析共纳入51项成本效用研究，其中14项研究涉及癌症，6项研究涉及冠心病。两项研究分别涉及血友病、多发性硬化症和类风湿性关节炎。其余研究涉及各种其他疾病。马尔可夫模型是最常用的模型，在45%的综述研究中得到应用。贴现率从零到7.2%不等。每QALY成本从一些骨科问题患者的放射照相成本中的0.144美元到血友病患者免疫耐受诱导（ITI）治疗中的4,551,521美元不等。显示出高度的异质性；因此，根据报告的每QALY成本或ICUR对干预措施进行排名会有偏差。
然而，收集所有经济评估研究并将它们汇总在一个表格中是有指导意义和信息价值的。表格中的信息反过来可用于重新分配资源以实现有效配置。总体而言，结果显示预防性项目从不同角度来看都是伊朗具有成本效益的干预措施。
