ObjectiveTo systematically evaluate pharmacoeconomic studies on Programmed cell death-1/Programmed cell death-ligand 1 (PD-1/PD-L1) inhibitors for advanced gastric cancer (GC) globally, providing evidence for healthcare policy formulation and clinical decision-making. MethodsWe conducted electronic searches in PubMed, Cochrane Library, Web of Science, ScienceDirect, Embase, CNKI, WanFang Data, and VIP databases, retrieving relevant literature published from inception to February 2025. Two researchers independently screened the literature, extracted data, and assessed study quality using the CHEERS 2022 checklist. We systematically summarized and analyzed the basic characteristics, model structures, methodological approaches, and economic outcomes of the included studies through inductive analysis. ResultsA total of 15 studies were included, with overall good quality. All included studies employed cost-utility analyses, among which 9 utilized partitioned survival models and 6 adopted Markov models. Direct medical costs were used as the cost calculation basis in all studies. Economic evaluations showed that most PD-1/PD-L1 inhibitors combined with chemotherapy were not cost-effective compared with chemotherapy alone. However, in patients with high PD-L1 expression, PD-1/PD-L1 inhibitor-based combination therapy demonstrated cost-effectiveness for advanced gastric cancer treatment. ConclusionThe economic viability of PD-1/PD-L1 inhibitor-based combination therapy for advanced GC varies significantly across regions due to drug pricing, economic status, and national contexts. Although most current regimens are not cost-effective, their clinical efficacy advantages suggest substantial future potential. Reducing drug prices is recommended to enhance drug accessibility in China.
Objective To systematically evaluate the quality of published pharmacoeconomics studies on Chinese patent medicines for neoplasms. Methods Datasets including CNKI, WanFang Data, VIP, SinoMed, PubMed, Web of Science, Cochrane Library, and EMbase were searched to collect pharmacoeconomics studies of Chinese patent medicines in neoplasms from the establishment of the database to September 30, 2022. Consolidated health economic evaluation reporting standards 2022 (CHEERS 2022) and quality of health economics studies (QHES) were used to evaluate the reporting quality and methodological quality. Results A total of 25 studies were included, with an average CHEERS 2022 coincidence rate of 40.09% and an average QHES score of 53.2. Conclusion The quantity and quality of pharmacoeconomics studies on Chinese patent medicines in neoplasms are insufficient and flawed. It is suggested to strenthen the collaboration between scientific research institutions and hospitals and standardize the pharmacoeconomics studies on Chinese patent medicines in neoplasms to provide hygienic decision-making evidence for Chinese patent medicines in neoplasms.
Markov model is one of the decision analysis models, which is widely used in pharmacoeconomic evaluation studies. In terms of dealing with changes of disease risks during different times, the transition probabilities among different Markov health states becomes hard to calculate. Nevertheless, survival analysis is an available resolution. In this paper, we introduced how to apply survival analysis in calculation of transition probability in time-dependent model based on cumulative probability with a case analysis on advanced gastric cancer Markov model, and provide more information for researchers to build models.
Objective To explore the effects on quality of life (QOL), the targeted rates of metabolic parameters and cost-effectiveness in newly diagnosed type 2 diabetic patients who underwent multifactorial intensive intervention. Methods One hundred and twenty seven cases in an intensive intervention and 125 cases in a conventional intervention group were investigated by using the SF-36 questionnaire. The comparison of QOL and the targeted rates of metabolic parameters between the two groups were made. We assessed the influence factors of QOL by stepwise regression analysis and evaluated the efficiency by pharmacoeconomic cost-effectiveness analysis. Results The targeted rates of blood glucose, blood lipid and blood pressure with intensive policies were significantly higher than those with conventional policy (P＜0.05). The intensive group’s role limitations due to physical problems (RP), general health (GH), vitality (VT), role limitation due to emotional problems (RE) and total scores after 6 months intervention were significantly higher than those of baseline (P＜0.05). The vitality scores and health transition (HT) of the intensive group were better than those of the conventional group after 6 months intervention. But the QOL scores of the conventional group were not improved after intervention. The difference of QOL’s total scores after intervention was related to that of HbA1c. The total cost-effectiveness rate of blood glucose, blood lipid, blood pressure control and the total cost-effectiveness rate of QOL with intensive policy were higher than those with the conventional policy. Conclusions Quality of life and the targeted rates of blood glucose, blood lipid and blood pressure in newly diagnosed type 2 diabetic patients with multifactorial intensive intervention policy are better and more economic than those with conventional policy.
ObjectiveTo systematically review the effectiveness and safety of salvianolate injection and Danshen injection for patients with angina pectoris, and evaluate the cost of drug.
MethodsWe electronically searched databases including PubMed, CENTRAL (Issue 4, 2013), CNKI, VIP and WanFang Data (2004.1 to 2013.5) for the randomized controlled trials (RCTs) on the comparison between salvianolate injection and Danshen injection for angina pectoris from January 2004 to May 2013. Relevant journals and conference proceedings were also manually retrieved. Two reviewers independently screened literature in accordance with the inclusion and exclusion criteria, extracted the data and assess the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software.
ResultsA total of 10 RCTs involving 1 196 patients were included. The results of meta-analysis showed that, salvianolate injection was obviously superior to Danshen injection in the effectiveness (OR=3.79, 95%CI 2.78 to 5.17, P < 0.000 01) and safety (OR=0.24, 95%CI 0.09 to 0.64, P=0.004), but lack of economic advantages in the treatment of the angina pectoris diseases.
ConclusionCurrent evidence indicates that, salvianolate injection is a safe and effective scheme for angina pectoris, and Danshen injection is considered as a economic method. Because of the limited quantity and quality of currently-available research, the aforementioned conclusion should be verified by strictly-designed and large-scale sample RCTs.
ObjectiveTo 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.
MethodsWe 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).
ResultsA 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.
ConclusionCompared to Amiodarone, RFA is a cost-effective therapy for AF.
ObjectiveTo introduce economic evaluation methods for anticancer-drugs with basket trial design, and to provide references for related research and decision-making. MethodsA case analysis was conducted on economic evaluation methods for anticancer-drugs with basket trial design, which was issued by Canadian Agency for Drugs and Technologies in Health (CADTH) in the Economic Guidance Report. Moreover, both the advantages and disadvantages of the methods were analyzed in accordance with the characteristics of basket trials. ResultsPooled analysis and tumor-specific analysis were two methods frequently employed in the case analysis. However, great uncertainties were available in both of them. The uncertainty of the former was mainly reflected in the heterogeneity of the targeted population, while the uncertainty of the latter was mainly shown in the insufficient sample size of the subgroup. ConclusionCurrently, economic evaluation methods for anticancer-drugs with basket trial design are immature. Thus, researchers are required to explore the methods of innovation evaluation with lower uncertainty; reimbursement decision-makers should fully consider the uncertainty of evaluation results and enterprises should collect the real-world data for the demands of evaluation to promote the reasonable allocation of healthcare resources in China.
ObjectiveTo systematically review the pharmacoeconomics research of coagulation factor Ⅷ for the treatment of hemophilia A. MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect pharmacoeconomic studies of coagulation factor Ⅷ for the treatment of hemophilia A from inception to February 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, qualitative systematic review was carried out from the aspects of research model, research parameters and uncertainty analysis. ResultsA total of 17 pharmacoeconomic studies were included. The overall quality of the included literature was relatively high, and most of them conformed to the basic framework of pharmacoeconomic research; however, there were still differences and deficiencies in model setting and parameter selection. Most results of the study evaluation showed that prophylaxis of coagulation factor Ⅷ had cost-effectiveness advantages over on-demand treatment. ConclusionCurrent evidence shows that the preventive treatment of coagulation factor Ⅷ may have certain cost-effectiveness advantages compared with on-demand treatment; however, the adaptability of this conclusion to China still needs to be analyzed.
Health economics analysis has become increasingly important in recent years. It is essential to master the use of relevant software to conduct research in health economics. TreeAge Pro software is widely used in the healthcare decision analysis. It can carry out decision analysis, cost-effectiveness analysis, and Monte Carlo simulation. With powerful functionlity and outstanding visualization, it can build Markov disease transition models to analyze Markov processes according to disease models and accomplish decision analysis with decision trees and influence diagrams. This paper introduces cost-effectiveness analysis based on Markov model with examples and explains the main graphs.
Objective To systematically evaluate the pharmacoeconomic vaule of chemotherapy combined with rituximab for patients with non-Hodgkin’s lymphomas (NHL). Methods A systematic literature search of cost-effectiveness studies on rituximab treating NHL published from 1998 to 2012 was carried out in following databases: PubMed, ScienceDirect, Health Technology Assessment (HTA) and Cochrane Database of Systematic Reviews (CDSR). And the references of included studies were also retrieved manually. The studies were screened according to the pre-designed inclusion and exclusion criteria, and the incremental cost- effectiveness ratio (ICER) in comparison between chemotherapy plus rituximab and chemotherapy alone was systematically evaluated according to the literature evaluation index system. Results The average ICER of Rituximab treating NHL was 16 318/QALY, 17 688/QALY, and 22 461/QALY in the UK, Mainland Europe, and US, respectively. All the reported ICERs in the included studies were below the implemented country-specific thresholds. Conclusion Based on present foreign literature, the integrated therapy of chemotherapy and rituximab for NHL is supposed to be a better cost-effective therapy with ICER below the implemented country-specific thresholds.
