中国药房2024，Vol.35Issue(8)：972-979,8.DOI:10.6039/j.issn.1001-0408.2024.08.13
PCSK9抑制剂预防高胆固醇血症患者心血管疾病的药物经济学评价系统综述
Systematic review of pharmacoeconomic evaluation on PCSK9 inhibitors for the prevention of cardiovascular disease in patients with hypercholesterolemia
摘要
Abstract
OBJECTIVE To systematically review the pharmacoeconomic evaluation literature about proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitors for the prevention of cardiovascular disease in patients with hypercholesterolemia,and to provide a reference for clinical treatment,health decision-making and future follow-up research.METHODS Retrieved from English and Chinese databases such as PubMed and CNKI,the pharmacoeconomic literature about PCSK9 inhibitors(evolocumab and alirocumab)for the prevention of cardiovascular disease in patients with hypercholesterolemia was collected from the establishment of the database to October 8,2023.The quality of the included literature was assessed with Consolidated Health Economic Evaluation Reporting Standards 2022(CHEERS 2022)scale.The descriptive analysis was performed for basic information,model structure,related parameters,sensitivity analysis and the results of included studies.RESULTS&CONCLUSIONS A total of 29 literature were included,with overall good quality.The evaluation mainly adopted the Markov model from the healthcare system,payer and societal perspective.The effectiveness and utility data mainly came from the previous studies;the direct cost was mainly considered with a discount rate of 1.5%-5.0%per year,while the willingness-to-pay threshold was often set at 1-3 times the gross domestic product per capita.Most health output indicators were measured in life years and quality-adjusted life years.The sensitivity analysis of most studies demonstrated the robustness and the main influential factor was the drug cost.Most Chinese studies showed that PCSK9 inhibitor was not cost-effective for the prevention of cardiovascular disease in patients with acute coronary syndrome,myocardial infarction and atherosclerotic cardiovascular disease.It was cost-effective to use PCSK9 inhibitors for the prevention of cardiovascular disease only in specific groups,such as patients with triple vessel disease,patients with newly diagnosed acute coronary syndrome and low-density lipoprotein cholesterol≥100 mg/dL.Future research should refer to the CHEERS 2022 scale to improve the design,and strive to select large-scale,high-quality data to enhance the quality of reports and the transparency of health decisions,so as to more accurately assess the cost-effectiveness of PCSK9 inhibitors.关键词
PCSK9抑制剂/依洛尤单抗/阿利西尤单抗/心血管疾病/高胆固醇血症/药物经济学评价Key words
PCSK9 inhibitors/evolocumab/alirocumab/cardiovascular disease/hypercholesterolemia/pharmacoeconomic evaluation分类
医药卫生引用本文复制引用
傅源源,周建成,邹颖,王璐颖,陈平钰,王永庆..PCSK9抑制剂预防高胆固醇血症患者心血管疾病的药物经济学评价系统综述[J].中国药房,2024,35(8):972-979,8.基金项目
江苏省卫生健康委员会药品临床综合评价项目(No.苏卫办药政[2022]1号) （No.苏卫办药政[2022]1号）
