射频消融术与胺碘酮比较治疗房颤的药物经济学评价

Pharmacoeconomic Evaluation of Radiofrequency Ablation versus Amiodarone for Atrial Fibrillation

目的系统评价射频消融与胺碘酮比较治疗房颤的经济学价值，为临床治疗方案选择、药物遴选、药物政策制定提供参考。方法计算机检索PubMed、TheCochraneLibrary、CNKI和CBM数据库，搜集国内外公开发表的射频消融与胺碘酮治疗房颤的药物经济学研究，检索时限均从2000年至2014年。南2位评价者独立筛选文献、提取资料，并评价纳入研究的方法学质量。根据临床效果、成本、增量成本效果比（ICER），评价射频消融与胺碘酮比较治疗房颤的成本-效果。结果共纳入3个研究，药物经济学评价结果显示，其ICER值分别为$7976～$29068、￡7763～￡27745和$59194。参照相应国家的意愿支付阀值，所有纳入研究的ICER值均在该国的意愿支付范围内。结论射频消融术与胺碘酮相比治疗房颤是具有成本，效果的方案。

Objective To systematically evaluate the pharmacoeconomic value of radiofrequency ablation （RFA） versus amiodarone in the treatment of atrial fibrillation （AF）, and to provide reference for treatment scheme selection, drug selection and the formulation of drug policy. Methods We searched databases including PubMed, The Cochrane Library, CNKI and CBM from 2000 to 2014 to collect pharmacoeconomic studies on RFA versus Amiodarone for treating AF. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. The cost-effectiveness of RFA and Amiodarone for AF was compared according to the cost, effectiveness, and incremental cost-effectiveness ratio （ICER）. Results A total of three studies were included. The results of pharmacoeconomic evaluation showed that the ICERs for each study were $7 976 to $29 068, ￡7 763 to ￡27 745, and $59 194, respectively. According to country-specific willingness to pay thresholds, the ICER of each included study was acceptable. Conclusion Compared to Amiodarone, RFA is a cost-effective therapy for AF.