Page 78 - 《中国药房》2023年24期
P. 78
·药物经济学·
全球血友病患者健康效用值的系统综述与Meta分析 Δ
冯俊超 1, 2, 3* ,李顺平 1, 2, 3 # ,房云海 ,史 钊 1, 2, 3 [1.山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中
4
心,济南 250012;2.国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),济南 250012;3.山东
大学健康偏好研究中心,济南 250012;4.山东省血液中心山东省血友病诊疗中心,济南 250014]
中图分类号 R956 文献标志码 A 文章编号 1001-0408(2023)24-3012-08
DOI 10.6039/j.issn.1001-0408.2023.24.10
摘 要 目的 系统梳理与评价全球血友病患者的健康效用值,为今后开展相关药物经济学评价和卫生技术评估提供基础数据支
持。方法 计算机检索中国知网、万方数据、维普网、中国生物医学文献数据库、PubMed、Embase、the Cochrane Library、Scopus和
Web of Science等数据库,收集血友病患者健康效用值测量的相关文献,检索时限均为建库至2023年2月。筛选文献、提取资料、
评价文献质量后,采用Stata 15.1软件对健康效用值进行Meta分析。结果 最终纳入38篇文献,纳入研究的健康效用值最高和最
低值分别为0.90和0.46,使用欧洲五维健康量表(EQ-5D)系列量表测量的研究最多(73.7%)。Meta分析结果显示,全球血友病患
者的健康效用值为0.69,95%置信区间为0.65~0.74,轻、中、重型患者健康效用值分别为0.79、0.70、0.64;伴有抑制物患者的健康
效用值(0.64)低于不伴有抑制物的患者(0.69);中国患者群体健康效用值为 0.55,高于伊朗患者(0.46),但低于其他发达国家。
结论 不同国家/地区研究结果具有一定的异质性,发达国家血友病患者健康效用值高于发展中国家;随着血友病严重程度的加
重,健康效用值下降趋势明显。
关键词 罕见病;血友病;健康效用值;系统评价;Meta分析
Systematic review and meta-analysis of health state utility for global patients with hemophilia
FENG Junchao 1, 2, 3 ,LI Shunping 1, 2, 3 ,FANG Yunhai ,SHI Zhao 1, 2, 3 [1. Center for Health Management and Policy
4
Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China;
2. NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan 250012, China;
3. Center for Health Preference Research, Shandong University, Jinan 250012, China;4. Shandong Haemophilia
Treatment Center, Shandong Blood Center, Jinan 250014, China]
ABSTRACT OBJECTIVE To systematically sort out and evaluate the health state utility of hemophiliac patients, and to provide
reliable parameters for conducting pharmacoeconomic evaluation and health technology assessment. METHODS Retrieved from
CNKI, Wanfang data, VIP, CBM, PubMed, Embase, the Cochrane Library, Scopus and Web of Science databases, relevant
literature about the measurement of health state utility in hemophiliac patients was collected from the inception to February 2023.
After screening literature, extracting data and evaluating the quality of literature, meta-analysis was performed for health state
utility with Stata 15.1 software. RESULTS Thirty-eight papers were finally included, with the highest and lowest health utility
values of 0.90 and 0.46, respectively. Those studies mostly adopted the EuroQol Five Dimensions Questionnaire (EQ-5D) (73.7%).
Results of meta-analysis showed that health state utility of global hemophiliac patients was 0.69,95% confidence interval was 0.65-
0.74; those of patients with mild, moderate and severe hemophilia were 0.79, 0.70, and 0.64, respectively; health state utility for
patients with inhibitors (0.64) was lower than that of patients without inhibitors (0.69); health state utility for the Chinese patient
population was 0.55, which was higher than that of Iranian patients (0.46), but lower than those of other developed countries.
CONCLUSIONS There is some heterogeneity in the results of the studies across countries/regions, with higher health state utility
in developed countries than in developing countries. As the
Δ 基金项目 国家自然科学基金面上项目(No.72174110)
severity of hemophilia increases, the trend of decreasing health
*第一作者 博士研究生。研究方向:罕见病诊疗保障与健康效用
值测量。E-mail:202221015@mail.sdu.edu.cn state utility is obvious.
# 通信作者 教授,博士生导师。研究方向:健康偏好与健康结果 KEYWORDS rare diseases; hemophilia; health state utility;
测量、罕见病诊疗与保障、卫生技术评估。E-mail:lishunping@sdu.edu. systematic evaluation; meta-analysis
cn
· 3012 · China Pharmacy 2023 Vol. 34 No. 24 中国药房 2023年第34卷第24期