中国药房2017，Vol.28Issue(17)：2318-2322,5.DOI:10.6039/j.issn.1001-0408.2017.17.04
成本-效用分析在我国医药卫生领域应用现状的系统综述
Application of Cost-Utility Analysis in Health Area of China:a Systematic Review
摘要
Abstract
OBJECTIVE:To evaluate the application of cost-utility analysis in health area of China in recent year. METH-ODS:From CNKI,Wanfang and VIP database,setting"cost utility"or"cost-utility"as"title"or"keyword",related literatures were retrieved during Jan. 2011-Dec. 2015,with subject field of"medical science and technology"in CNKI,"medical science"in Wanfang database,"clinical medicine""Chinese medicine""preclinical medicine""preventive medicine hygiene"or"pharmacy"in VIP. The comprehensive evaluation involved research design,research perspective,cost measurement,utility index and measure-ment method,cost-utility analysis index,discount and sensitivity analysis. RESULTS:A total of 31 literatures meeting inclusion cri-teria were selected,including 12 prospective studies,9 retrospective studies,9 Markov model studies,1 mixed study. Thirteen lit-eratures worked in medical institutions. Seven literatures explicitly mentioned research perspective;most literatures only measured direct cost(19 literatures)and adopted QALY as utility index(27 literatures). Twenty eight literatures described measurement meth-od of utility index(direct measurement,indirect measurement or literature method)in detail. More than half(16 literatures)analyzed cost-utility by using cost-utility ratio(CUR);7 literatures adopted incremental cost-utility ratio(ICUR)and 6 literatures adopted both CUR and ICUR. Five literatures used the threshold of ICUR. Eleven literatures described discount,and the majority was Markov mod-el study. Sensitivity analysis was conducted in 16 literatures,among which 11 literatures adopted single factor analysis. The most com-monly involved influential factor was cost,followed by utility value and discount rate. CONCLUSIONS:Cost-utility analysis has been widely used in China,but the quality and normalization of studies have much room for improvement. Learning more experiences from international researches can help to promote the quality of domestic studies,guide the practice of clinical rational use of drugs and sup-port the government decision-making process and medical insurance payment in the future.关键词
成本-效用分析/医药卫生领域/现状/系统综述Key words
Cost-utility analysis/Health area/Current situation/Systematic review分类
医药卫生引用本文复制引用
周莉,叶露..成本-效用分析在我国医药卫生领域应用现状的系统综述[J].中国药房,2017,28(17):2318-2322,5.基金项目
上海市卫生和计划生育委员会第四轮公共卫生三年行动计划重点学科建设计划资助项目(No.15GWZK0901) （No.15GWZK0901）
