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2型糖尿病治疗药物经济学评价模型的分析研究
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篇名: 2型糖尿病治疗药物经济学评价模型的分析研究
TITLE: Analysis Study of Pharmacoeconomic Evaluation Model of Therapy for Type 2 Diabetes Mellitus
摘要: 目的:分析近5年2型糖尿病(T2DM)治疗药物经济学评价研究中涉及模型的基本特征及其应用情况,为T2DM药物经济学评价模型的选择和完善提供参考。方法:计算机检索PubMed、Embase、中国知网、万方数据库、维普网等数据库中2015年1月1日-2019年12月31日公开发表的T2DM治疗药物的经济学评价文献,从模型基本结构、治疗方案设定、短期治疗效果、并发症模拟、模型有效性验证、应用频次等方面对纳入模型进行分析。结果:共纳入81篇文献,涉及14个模型,如CORE模型、Cardiff模型、ECHO模型等;模型多以第三方付费者角度,采用马尔可夫或微观马尔可夫模拟方法测算患者终身的健康产出和成本;7个模型可模拟设定2~4个治疗方案;模型中分析的短期治疗效果主要包糖尿病并发症相关的危险因素(如糖化血红蛋白水平、体质量等)和用药不良反应情况;多数模型采用中间指标模拟并发症发生情况,涵盖的并发症数量介于3~15个之间;模型有效性的效度包括表面效度、内部效度、外部效度等;14个模型中,近5年应用频次较多的模型主要为经过有效性验证的长期模型,其中CORE模型应用次数(38/81,46.91%)最多、Cardiff模型(12/81,14.81%)次之。结论:14个模型的基本结构类似,模型差异主要体现在治疗方案设置、考量的短期治疗效果、并发症数量及其模拟方法等3个方面。现有证据下较理想的模型选择为CORE模型和Cardiff模型。
ABSTRACT: OBJECTIVE:To analyze th e general characteristics and application of the models used in the pharmacoeconomic evaluation of type 2 diabetes mellitus (T2DM)therapy during the past 5 years,and to provide reference for the selection and improvement of T 2DM pharmacoeconomic model. METHODS :Retrieved from PubMed ,Embase,CNKI,Wanfang database and VIP during Jan. 1st,2015 to Dec. 31st,2019,pharmacoeconomic evaluation literatures about T 2DM therapy were collected ;the included model was analyzed in respects of general structure ,therapy plan establishment , short-term therapeutic efficacy , complication simulation ,model effectiveness validation ,application frequency. RESULTS :A total of 81 literatures were included , involving 14 models,such as CORE model ,Cardiff model ,ECHO model ,etc. Mostly ,Markov or micro Markov simulation method were adopted to measure the patient ’s lifetime health outcome and cost mostly from the point of view of third-party payer. Seven models could simulate 2-4 therapy plans ;short-term efficacy mainly included risk factors of diabetic complications (such as glycosylated hemoglobin level and body mass )and adverse drug reactions. Most models used intermediate indexes to simulate the occurrence of complications ,and the number of complications ranged from 3 to 15;the validity of model effectiveness included surface validity ,internal validity and external validity ,etc. Among 14 models,the most frequently used models in the past 5 years were long-term models that had been validated ,among which CORE model had the most application times (38/81,46.91%), followed by Cardiff model (12/81,14.81%). CONCLUSIONS :The 14 models have similar structure. The differences of the models are mainly reflected in 3 aspects as therapy plan setting, considered short-term efficacy , the number of model are ideally choose based on available evidences.
期刊: 2020年第31卷第19期
编辑: 刘海娇,王雅洁,吴玉霞,刘朝一,刘西涛,徐伟
AUTHORS: LIU Haijiao ,WANG Yajie,WU Yuxia,LIU Chaoyi ,LIU Xitao,XU Wei
关键字: 2型糖尿病;药物经济学;模型
KEYWORDS: Type 2 diabetes;Pharmacoeconomics;Model
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