国内靶向药物治疗结直肠癌的经济学研究系统评价

    Systematic Review of Economic Evaluation of Targeted Drugs for Colorectal Cancer Treatment in China

    • 摘要: 目的 了解国内靶向药物治疗结直肠癌的经济学评价研究进展,总结其模型结构、参数纳入与研究结果。方法 计算机检索PubMed、Web of Science、Embase、Scopus、CNKI、VIP、Wanfang Data数据库,搜集结直肠癌靶向药物的经济学研究,检索时限为建库至2022年7月31日。利用Excel提取文献信息,使用CHEERS 2022版质量评价表评估文献质量。结果 初检共获得871篇文献,最终纳入17篇,文献质量整体较好,涉及5种靶向药物,均为成本-效用分析,除1篇使用前瞻性队列研究外,其余均使用模型研究。西妥昔单抗、贝伐珠单抗、帕尼单抗与标准化疗相比均不具经济性。抗表皮生长因子受体单克隆抗体(Anti-EGFR mAb)一线治疗RAS野生型左侧转移性结直肠癌较贝伐珠单抗更具经济性。呋喹替尼相较瑞戈非尼具有经济学优势。结论 未来建议综合比较多种靶向治疗方案的经济性并关注更多靶向治疗选择,并注意生物标志物和原发肿瘤部位的影响。国家医保报销、企业优惠政策和国产新药研发均可促进药品惠及患者。

       

      Abstract: OBJECTIVE To inform the progress in studies on economic evaluation of targeted drugs for colorectal cancer treatment in China, and to summarize their model structure, parameter inclusion and research results. METHODS PubMed, Web of Science, Embase, Scopus, CNKI, VIP, Wanfang Data databases were searched from inception to July 31, 2022 to collect studies about the economic evaluation of targeted drugs for colorectal cancer. The information of literature was extracted using Excel, and the quality of the literatures was assessed using the CHEERS 2022. RESULTS A total of 871 literatures were obtained, and finally 17 were included. The quality of literatures were good, involving 5 targeted drugs, all of which were cost-utility analysis. Only one study used prospective cohort study and rest used modelling study. Compared with standard chemotherapy, cetuximab, bevacizumab, and panitumumab were not cost-effective. Anti-epidermal growth factor receptor monoclonal antibody(Anti-EGFR mAb) was more cost-effective than bevacizumab as a first-line treatment for patients with RAS wild-type left-sided metastatic colorectal cancer. Fruquintinib had economic advantages over regorafenib. CONCLUSION It is suggested to comprehensively compare the economy of multiple various targeted therapeutic regimens and focus on more targeted therapy options in the future, with attention to the impact of biomarkers and primary tumor location. National medical insurance reimbursement, preferential policies of enterprises and domestic new drug research and development can bring the benefit of drugs to patients.

       

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