Comparison and selection of application methods of meta-analysis results in economic evaluations_Chinese Journal of Evidence-Based Medicine

Authors：

GUAN Xin ^# , LI Hongchao ^# , YAO Jiaqi , LIANG Wenyan ,  MA Aixia

School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, P.R.China;

Corresponding?author：

MA Aixia, Email: ma86128@sina.com

Keywords：

Meta-analysis; Cost-effectiveness analysis; Decision tree model; Method application

DOI：

10.7507/1672-2531.201807133

Video：

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ObjectivesTo compare the common application methods of meta-analysis results used in economic evaluations so as to provide reference and suggestions for similar economic evaluations in future.MethodsFour methods were used to calculate the effectiveness deriving from meta-analysis of omeprazole and esomeprazole in the treatment of peptic ulcer, then substituted into the decision tree model to perform cost-effectiveness analysis.ResultsMethod 1 used the risk difference as the incremental effectiveness. The ICER was ￥2 420, and the equal probability point of the cost-effectiveness acceptability curve (CEAC) in the probability sensitivity analysis was approximately ￥2 600. Method 2 used the effective rate of the study group in high-quality literatures as the benchmark, calculated the effective rate of the control group according to the RR. The ICER was ￥2 016, and the equal probability point of the CEAC was approximately￥2 000. Method 3 was based on the effective rate of the control group in high-quality literatures to calculate the effective rate of the study group according to RR. The ICER was ￥2 420 and the equal probability point of the CEAC was approximately￥2 200; Method 4 used literature weights to calculate the effectiveness, the ICER is ￥2 420, and the equal probability point of the CEAC was about ￥2 400.ConclusionsThe results of the four methods share little difference, and the sensitivity analysis results show that the base case analysis results are more robust. However, in the application process, method 1 lacks specific effectiveness of the two groups and underestimate the variation range of the effectiveness difference when one-way sensitivity analysis was performed. Relevant assumptions are further required to limit the possibility of effectiveness calculated greater than 1 in sensitivity analysis among method 2 and 3. Comprehensively, method 4 can be recommended in the economic evaluations for fewer defects of calculating effectiveness.

Citation： GUAN Xin, LI Hongchao, YAO Jiaqi, LIANG Wenyan, MA Aixia. Comparison and selection of application methods of meta-analysis results in economic evaluations. Chinese Journal of Evidence-Based Medicine, 2018, 18(11): 1224-1231. doi: 10.7507/1672-2531.201807133 Copy

1.	張天嵩, 鐘文昭, 李博. 實用循證醫學方法學(第 2 版). 長沙: 中南大學出版社, 2014.
2.	陳耀龍, 李幼平, 杜亮, 等. 醫學研究中證據分級和推薦強度的演進. 中國循證醫學雜志, 2008, 8(2): 127-133.
3.	劉強, 李洪超, 馬愛霞. 基于決策樹模型對我國中重度抑郁癥臨床常用藥物治療方案選擇的成本-效果分析. 中國循證醫學雜志, 2016, 16(6): 628-634.
4.	Ali SA, Donahue RM, Qureshi H, et al. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis, 2009, 13(1): 9-19.
5.	曾憲濤, 冷衛東, 郭毅, 等. Meta 分析系列之一: Meta 分析的類型. 中國循證心血管醫學雜志, 2012, 4(1): 3-5.
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7.	鄧麗清, 吳明東, 勞海忠, 等. 質子泵抑制劑埃索美拉唑三聯療法在十二指腸潰瘍中的療效觀察. 河北醫學, 2009, 15(2): 186-188.
8.	徐玉玲, 孫春林. 埃索美拉唑三聯療法治療 Hp 陽性十二指腸潰瘍的療效觀察. 中國現代醫生, 2008, (21): 143-144.
9.	曠歷瓊, 巴合達娜提, 李悟. 埃索美拉唑三聯與奧美拉唑三聯治療 Hp 陽性十二指腸潰瘍的對比研究. 現代醫藥衛生, 2007, (17): 2541-2542.
10.	陳元鴻, 王婉梅, 王皓, 等. 埃索美拉唑三聯與奧美拉唑三聯療法治療 Hp 陽性十二指腸潰瘍對比研究. 第一軍醫大學學報, 2005, (8): 1045-1047.
11.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.1.0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
12.	Tulassay Z, Kryszewski A, Dite P, et al. One week of treatment with esomeprazole-based triple therapy eradicates Helicobacter pylori and heals patients with duodenal ulcer disease. Eur J Gastroenterol Hepatol, 2001, 13(12): 1457-1465.
13.	歐陽穎, 王志鳳, 江雪梅. 埃索美拉唑與奧美拉唑治療十二指腸潰瘍的療效對比. 新疆醫科大學學報, 2006, (3): 207-209.
14.	王云霄, 曹玉, 時萍. 埃索美拉唑三聯療法治療十二指腸球部潰瘍療效分析. 山東醫藥, 2007, (16): 38-39.
15.	顏開華, 朱明艷, 胡林, 等. 埃索美拉唑三聯與奧美拉唑三聯治療 HP 陽性十二指腸潰瘍的臨床對比研究. 中國臨床新醫學, 2008, (S1): 34-36.
16.	張秋敏, 張雷, 王建剛. 埃索美拉唑治療消化性潰瘍的臨床研究. 中國藥師, 2008, (4): 442-443.
17.	史美娟, 趙換. 埃索美拉唑對幽門螺桿菌陽性的十二指腸球部潰瘍患者的療效分析. 山西醫藥雜志(下半月刊), 2010, 39(9): 822-823.
18.	彭家先, 曹觀新. 埃索美拉唑治療 HP 感染消化性潰瘍 60 例療效觀察. 中國醫藥指南, 2011, 9(29): 266-267.
19.	于博坤. 阿莫西林、克拉霉素、埃索美拉唑聯合治療消化性潰瘍療效觀察. 吉林醫學, 2012, 33(9): 1872.
20.	黃治國, 蘇汝開. 埃索美拉唑三聯療法治療幽門螺桿菌陽性十二指腸潰瘍 50 例療效觀察. 中國美容醫學, 2012, 21(12): 259-260.
21.	常振紅, 張建強. 埃索美拉唑三聯療法治療幽門螺桿菌陽性十二指腸潰瘍的療效觀察. 臨床合理用藥雜志, 2012, 5(4): 62-63.
22.	白揚. 比較埃索美拉唑三聯與奧美拉唑三聯療法治療幽門螺桿菌陽性十二指腸球部潰瘍的臨床療效. 北方藥學, 2017, 14(5): 94-95.
23.	Wu B, Dong B, Xu Y, et al. Economic evaluation of first-line treatments for metastatic renal cell carcinoma: a cost-effectiveness analysis in a health resource-limited setting. PLoS One, 2012, 7(3): e32530.

1. 張天嵩, 鐘文昭, 李博. 實用循證醫學方法學(第 2 版). 長沙: 中南大學出版社, 2014.
2. 陳耀龍, 李幼平, 杜亮, 等. 醫學研究中證據分級和推薦強度的演進. 中國循證醫學雜志, 2008, 8(2): 127-133.
3. 劉強, 李洪超, 馬愛霞. 基于決策樹模型對我國中重度抑郁癥臨床常用藥物治療方案選擇的成本-效果分析. 中國循證醫學雜志, 2016, 16(6): 628-634.
4. Ali SA, Donahue RM, Qureshi H, et al. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis, 2009, 13(1): 9-19.
5. 曾憲濤, 冷衛東, 郭毅, 等. Meta 分析系列之一: Meta 分析的類型. 中國循證心血管醫學雜志, 2012, 4(1): 3-5.
6. 劉國恩. 中國藥物經濟學評價指南及導讀(2015 版). 北京: 科學出版社, 2015: 205.
7. 鄧麗清, 吳明東, 勞海忠, 等. 質子泵抑制劑埃索美拉唑三聯療法在十二指腸潰瘍中的療效觀察. 河北醫學, 2009, 15(2): 186-188.
8. 徐玉玲, 孫春林. 埃索美拉唑三聯療法治療 Hp 陽性十二指腸潰瘍的療效觀察. 中國現代醫生, 2008, (21): 143-144.
9. 曠歷瓊, 巴合達娜提, 李悟. 埃索美拉唑三聯與奧美拉唑三聯治療 Hp 陽性十二指腸潰瘍的對比研究. 現代醫藥衛生, 2007, (17): 2541-2542.
10. 陳元鴻, 王婉梅, 王皓, 等. 埃索美拉唑三聯與奧美拉唑三聯療法治療 Hp 陽性十二指腸潰瘍對比研究. 第一軍醫大學學報, 2005, (8): 1045-1047.
11. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.1.0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
12. Tulassay Z, Kryszewski A, Dite P, et al. One week of treatment with esomeprazole-based triple therapy eradicates Helicobacter pylori and heals patients with duodenal ulcer disease. Eur J Gastroenterol Hepatol, 2001, 13(12): 1457-1465.
13. 歐陽穎, 王志鳳, 江雪梅. 埃索美拉唑與奧美拉唑治療十二指腸潰瘍的療效對比. 新疆醫科大學學報, 2006, (3): 207-209.
14. 王云霄, 曹玉, 時萍. 埃索美拉唑三聯療法治療十二指腸球部潰瘍療效分析. 山東醫藥, 2007, (16): 38-39.
15. 顏開華, 朱明艷, 胡林, 等. 埃索美拉唑三聯與奧美拉唑三聯治療 HP 陽性十二指腸潰瘍的臨床對比研究. 中國臨床新醫學, 2008, (S1): 34-36.
16. 張秋敏, 張雷, 王建剛. 埃索美拉唑治療消化性潰瘍的臨床研究. 中國藥師, 2008, (4): 442-443.
17. 史美娟, 趙換. 埃索美拉唑對幽門螺桿菌陽性的十二指腸球部潰瘍患者的療效分析. 山西醫藥雜志(下半月刊), 2010, 39(9): 822-823.
18. 彭家先, 曹觀新. 埃索美拉唑治療 HP 感染消化性潰瘍 60 例療效觀察. 中國醫藥指南, 2011, 9(29): 266-267.
19. 于博坤. 阿莫西林、克拉霉素、埃索美拉唑聯合治療消化性潰瘍療效觀察. 吉林醫學, 2012, 33(9): 1872.
20. 黃治國, 蘇汝開. 埃索美拉唑三聯療法治療幽門螺桿菌陽性十二指腸潰瘍 50 例療效觀察. 中國美容醫學, 2012, 21(12): 259-260.
21. 常振紅, 張建強. 埃索美拉唑三聯療法治療幽門螺桿菌陽性十二指腸潰瘍的療效觀察. 臨床合理用藥雜志, 2012, 5(4): 62-63.
22. 白揚. 比較埃索美拉唑三聯與奧美拉唑三聯療法治療幽門螺桿菌陽性十二指腸球部潰瘍的臨床療效. 北方藥學, 2017, 14(5): 94-95.
23. Wu B, Dong B, Xu Y, et al. Economic evaluation of first-line treatments for metastatic renal cell carcinoma: a cost-effectiveness analysis in a health resource-limited setting. PLoS One, 2012, 7(3): e32530.

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