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Abstract：
OBJECTIVE: To review the evidence on the cost-effectiveness of ocriplasmin as a treatment for vitreomacular traction (VMT), and to estimate the impact on the Spanish National Health System (NHS).
METHODS: 1) Systematic review. The following databases were searched in January 2015: MEDLINE, PREMEDLINE, EMBASE, CRD, the Cochrane Library, and key websites. Selection criteria were: full economic evaluations that compared ocriplasmin with usual care (\'watch and wait\' and/or vitrectomy) in patients with VMT. The outcomes to extract were costs of the alternatives and the incremental cost-effectiveness ratio. Studies of budget impact analysis were also included. The methodological quality was assessed, and a narrative synthesis of the included studies was carried out. 2) Estimation of budget impact. The impact on the budget as a result of the introduction of ocriplasmin in the NHS was estimated, including data from different sources.
RESULTS: Six studies were identified, none of them performed in Spain. The two best studies concluded that ocriplasmin is cost-effective in their respective countries (Canada and United Kingdom), but only in patients with certain conditions (without epiretinal membrane, for example). The results of the budget impact analysis are different between countries. The analysis for Spain showed that the introduction of ocriplasmin would mean a saving over 1 million Euros for the NHS in 5 years.
CONCLUSIONS: The cost-effectiveness of ocriplasmin has not been demonstrated in Spain. However, good studies performed in other countries found that ocriplasmin is cost-effective in selected patients. Given the current prices in Spain, ocriplasmin could involve a saving for the Spanish NHS.
METHODS: 1) Systematic review. The following databases were searched in January 2015: MEDLINE, PREMEDLINE, EMBASE, CRD, the Cochrane Library, and key websites. Selection criteria were: full economic evaluations that compared ocriplasmin with usual care (\'watch and wait\' and/or vitrectomy) in patients with VMT. The outcomes to extract were costs of the alternatives and the incremental cost-effectiveness ratio. Studies of budget impact analysis were also included. The methodological quality was assessed, and a narrative synthesis of the included studies was carried out. 2) Estimation of budget impact. The impact on the budget as a result of the introduction of ocriplasmin in the NHS was estimated, including data from different sources.
RESULTS: Six studies were identified, none of them performed in Spain. The two best studies concluded that ocriplasmin is cost-effective in their respective countries (Canada and United Kingdom), but only in patients with certain conditions (without epiretinal membrane, for example). The results of the budget impact analysis are different between countries. The analysis for Spain showed that the introduction of ocriplasmin would mean a saving over 1 million Euros for the NHS in 5 years.
CONCLUSIONS: The cost-effectiveness of ocriplasmin has not been demonstrated in Spain. However, good studies performed in other countries found that ocriplasmin is cost-effective in selected patients. Given the current prices in Spain, ocriplasmin could involve a saving for the Spanish NHS.
摘要：
目的：回顾ocriplasmin作为玻璃体黄斑牵引（VMT）治疗的成本效益的证据，并估计对西班牙国家卫生系统（NHS）的影响。
方法：1)系统评价。2015年1月搜索了以下数据库：MEDLINE，PREMEDLINE,EMBASE,CRD,Cochrane图书馆,和关键网站。选择标准是：全面的经济评估，比较了VMT患者的ocriplasmin与常规护理（“观察并等待”和/或玻璃体切除术）。提取的结果是替代方案的成本和增量成本效益比。还包括预算影响分析研究。评估了方法学质量，并对纳入的研究进行了叙述性综合。2)预算影响的估算。估计了在NHS中引入ocriplasmin对预算的影响，包括来自不同来源的数据。
结果：确定了六项研究，他们都没有在西班牙演出。两项最佳研究得出的结论是，ocriplasmin在各自国家（加拿大和英国）具有成本效益，但仅限于患有某些疾病的患者（没有视网膜前膜，例如）。各国的预算影响分析结果不同。对西班牙的分析表明，引入ocriplasmin将意味着在5年内为NHS节省超过100万欧元。
结论：在西班牙尚未证明奥氏酶的成本效益。然而,在其他国家进行的良好研究发现，在选定的患者中，ocriplasmin具有成本效益。鉴于西班牙目前的价格，ocriplasmin可能涉及为西班牙NHS节省费用。
方法：1)系统评价。2015年1月搜索了以下数据库：MEDLINE，PREMEDLINE,EMBASE,CRD,Cochrane图书馆,和关键网站。选择标准是：全面的经济评估，比较了VMT患者的ocriplasmin与常规护理（“观察并等待”和/或玻璃体切除术）。提取的结果是替代方案的成本和增量成本效益比。还包括预算影响分析研究。评估了方法学质量，并对纳入的研究进行了叙述性综合。2)预算影响的估算。估计了在NHS中引入ocriplasmin对预算的影响，包括来自不同来源的数据。
结果：确定了六项研究，他们都没有在西班牙演出。两项最佳研究得出的结论是，ocriplasmin在各自国家（加拿大和英国）具有成本效益，但仅限于患有某些疾病的患者（没有视网膜前膜，例如）。各国的预算影响分析结果不同。对西班牙的分析表明，引入ocriplasmin将意味着在5年内为NHS节省超过100万欧元。
结论：在西班牙尚未证明奥氏酶的成本效益。然而,在其他国家进行的良好研究发现，在选定的患者中，ocriplasmin具有成本效益。鉴于西班牙目前的价格，ocriplasmin可能涉及为西班牙NHS节省费用。
