依奇珠单抗治疗中重度斑块状银屑病药物经济学评价的系统分析

Cost-effectiveness Analysis and Systematic Review of Ixekizumab in the Treatment of Moderate-to-Severe Plaque Psoriasis

目的了解文献中关于生物制剂用于中重度斑块状银屑病的经济学研究情况,探究国内新上市的生物制剂依奇珠单抗是否更具有成本效果。方法计算机系统检索PubMed、Web of Science、Cochrane Library和中国知网、万方数据库等数据库,并辅以手工检索,检索时间为2016年1月1日-2020年2月31日,中英文检索词包括"依奇珠单抗""银屑病""药物经济学""成本-效益分析""成本-效果分析""成本-效用分析""Ixekizumab""Psoriasis""Pharmacoeconomics""Cost-benefit analysis""Cost-effectiveness analysis""Cost-utility analysis"等,根据纳入与排除标准筛选文献,收集依奇珠单抗治疗中重度斑块状银屑病的相关药物经济学研究并对其进行质量评价。对纳入研究的研究模型、药物经济学评价结果以及敏感性评价结果等进行归纳、总结。结果最终纳入文献5篇,涉及5项研究。纳入研究质量较高;研究均分布在国外,包括美国、英国和西班牙;4篇研究采用Markov模型,1篇研究采用决策树模型;从健康结局来看,在阈值明确的条件下,依奇珠单抗单药或以依奇珠单抗作为一线生物治疗药物的治疗序列具有经济学优势。结论依奇珠单抗在治疗中重度斑块状银屑病中具有一定的经济学优势,且较高的可接受支付值和成本效果阈值将推动依奇珠单抗的应用。

Objective To understand the economic research on the use of biological agents for moderate-to-severe plaque psoriasis in literature and to explore the cost-effectiveness of ixekizumab,which is a newly marketed biological agent in China.Methods We searched the PubMed,Web of Science,Cochrane Library,CNKI,Wanfang database and other databases for relevant studies between January 1,2016 and February 31,2020,supplemented with manual search.The search words used included"Ixekizumab""Psoriasis""Pharmacoeconomics""Cost-benefit analysis""Cost-effectiveness analysis""Cost-utility analysis"in both Chinese and English.According to the inclusion and exclusion criteria,the literature was screened,and the pharmacoeconomic studies on the treatment of plaque psoriasis were collected and evaluated.The research models,pharmacoeconomic evaluation results and sensitivity evaluation results were summarized.Results Finally five articles involving five studies were included.The included studies was of high quality;all the studies were conducted in western countries,including the United States,the United Kingdom and Spain.Among them,four studies used Markov model,and one study used decision tree model;from the perspective of health outcomes,under the condition of clear threshold,the treatment sequence of ezizumab monotherapy or taking ezizumab as the first-line biological therapy drug is much more economical.Conclusion Ixekizumab has certain economic advantages in the treatment of moderate-to-severe plaque psoriasis,and the higher acceptable payment value and cost-effectiveness threshold will encourage the application of ixekizumab in the treatment of plaque psoriasis.