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关于决策分析模型在肺动脉高压靶向治疗药物经济学评价中当前应用状况的系统评价

A systematic review of the current application status of decision-analytical models in the pharmacoeconomic evaluation of targeted therapies for pulmonary arterial hypertension.

作者信息

Dong Wenxing, Zhang Zhe, Wang Xiaodan, Ma Xiaolong, Chu Mingming, Li Yulian, Xiang Xing, Peng Cheng, Zhang Rong

机构信息

Department of Pharmacy, The Second Affiliated Hospital of Army Medical University, Chongqing, People's Republic of China.

Department of Pharmacy, Beidaihe Rehabilitation and Recuperation Center of Joint Logistics Support Forces, Qinhuangdao, People's Republic of China.

出版信息

Cost Eff Resour Alloc. 2025 Apr 11;23(1):13. doi: 10.1186/s12962-025-00621-z.

Abstract

BACKGROUND

The implementation of targeted drug therapy results in a significant improvement in both survival rates and quality of life among patients diagnosed with pulmonary arterial hypertension (PAH), concurrently imposing a greater financial burden on them. The use of pharmacoeconomic evaluation based on decision-analytical models is extensively employed in the rational allocation of healthcare resources.

OBJECTIVES

The present study conducted a systematic review of the literature on the pharmacoeconomic evaluation of drugs for treating PAH, with a focus on summarizing the composition and sources of parameters in decision-analytical models. This study aims to provide methodological guidance for future economic research.

METHODS

The review was conducted across six databases (PubMed, Embase, the Cochrane Library, CNKI, VIP, WanFang Data) and two health technology assessment agency websites (NHS EED, INAHTA). The characteristics of each study and the compositional details of the decision-analytical models are extracted.

RESULTS

In total, 13 published studies were included. The pharmacoeconomic evaluation methods employed in the studies included cost-effectiveness analysis (CEA) and cost-utility analysis (CUA). The decision analysis models employed in all 13 studies were Markov models. The models were all constructed on the basis of the World Health Organization (WHO) functional class, with variations in parameter settings and sources.

CONCLUSIONS

All 13 Markov models provided useful insight into PAH modeling. Future research in this field can employ these research methods according to diverse research objectives. The utility values were derived from a single source; therefore, future studies should evaluate the quality of life in patients with PAH across varying disease severities.

摘要

背景

靶向药物治疗的实施使肺动脉高压(PAH)患者的生存率和生活质量均有显著提高,但同时也给他们带来了更大的经济负担。基于决策分析模型的药物经济学评价在医疗资源的合理分配中得到广泛应用。

目的

本研究对治疗PAH药物的药物经济学评价文献进行系统综述,重点总结决策分析模型中参数的组成和来源。本研究旨在为未来的经济学研究提供方法学指导。

方法

在六个数据库(PubMed、Embase、Cochrane图书馆、中国知网、维普资讯、万方数据)和两个卫生技术评估机构网站(NHS EED、INAHTA)上进行检索。提取每项研究的特征以及决策分析模型的组成细节。

结果

共纳入13项已发表的研究。研究中采用的药物经济学评价方法包括成本效果分析(CEA)和成本效用分析(CUA)。所有13项研究采用的决策分析模型均为马尔可夫模型。这些模型均基于世界卫生组织(WHO)功能分级构建,参数设置和来源有所不同。

结论

所有13个马尔可夫模型为PAH建模提供了有用的见解。该领域未来的研究可根据不同的研究目标采用这些研究方法。效用值来自单一来源;因此,未来的研究应评估不同疾病严重程度的PAH患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8106/11992868/ac058720574c/12962_2025_621_Fig1_HTML.jpg

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