Abstract：
The management of chronic myeloid leukemia is associated with an extensive economic burden, and as novel interventions are being tested in this disease, understanding the comparative effectiveness is of interest. Findings and conclusions of this important issue continue to evolve with improvements in clinical research and economic understanding. This systematic literature review aims to conduct a comprehensive assessment of economic evaluations in chronic phase chronic myeloid leukemia.
Embase®, MEDLINE®, and the National Health Service Economic Evaluation Database were searched on 4 July, 2022 to identify economic evaluations of chronic myeloid leukemia. Health technology assessment websites and key conference proceedings were also searched. Economic evaluations comparing treatment options in adult patients with chronic phase chronic myeloid leukemia were included. The quality of the studies were assessed using Drummond\'s checklists.
The search retrieved 47 studies and 16 health technology assessments that fulfilled the eligibility criteria. Most were cost-utility analyses (23 studies and 11 health technology assessments) and were from the USA (n = 15) and China (n = 7). Twenty-seven studies and six health technology assessments included only patients with chronic phase chronic myeloid leukemia. Most models had a Markov structure, a 1 year to lifetime time horizon, and a 1-month cycle length. Commonly assessed treatments were various tyrosine kinase inhibitors (imatinib, nilotinib, dasatinib, bosutinib, and ponatinib) and other interventions such as interferon-α, hydroxyurea, and allogeneic stem cell transplant.
In patients with newly diagnosed chronic myeloid leukemia, imatinib regimens were cost effective, mostly owing to the availability of generics. Nilotinib and dasatinib were generally cost effective as second-line agents for patients who were resistant or intolerant to imatinib. Though progress has been made to better characterize the cost effectiveness of first-line and second-line chronic myeloid leukemia therapies, the paucity of published cost-effectiveness studies of third-line treatments increases the uncertainty associated with economic evaluations of later lines of therapy.
Embase®, MEDLINE®, and the National Health Service Economic Evaluation Database were searched on 4 July, 2022 to identify economic evaluations of chronic myeloid leukemia. Health technology assessment websites and key conference proceedings were also searched. Economic evaluations comparing treatment options in adult patients with chronic phase chronic myeloid leukemia were included. The quality of the studies were assessed using Drummond\'s checklists.
The search retrieved 47 studies and 16 health technology assessments that fulfilled the eligibility criteria. Most were cost-utility analyses (23 studies and 11 health technology assessments) and were from the USA (n = 15) and China (n = 7). Twenty-seven studies and six health technology assessments included only patients with chronic phase chronic myeloid leukemia. Most models had a Markov structure, a 1 year to lifetime time horizon, and a 1-month cycle length. Commonly assessed treatments were various tyrosine kinase inhibitors (imatinib, nilotinib, dasatinib, bosutinib, and ponatinib) and other interventions such as interferon-α, hydroxyurea, and allogeneic stem cell transplant.
In patients with newly diagnosed chronic myeloid leukemia, imatinib regimens were cost effective, mostly owing to the availability of generics. Nilotinib and dasatinib were generally cost effective as second-line agents for patients who were resistant or intolerant to imatinib. Though progress has been made to better characterize the cost effectiveness of first-line and second-line chronic myeloid leukemia therapies, the paucity of published cost-effectiveness studies of third-line treatments increases the uncertainty associated with economic evaluations of later lines of therapy.
摘要：
慢性粒细胞白血病的治疗与广泛的经济负担有关，随着新的干预措施正在对这种疾病进行测试，了解比较有效性是有意义的。随着临床研究和经济理解的改善，这一重要问题的发现和结论继续发展。本系统文献综述旨在对慢性期慢性粒细胞白血病的经济学评价进行全面评估。
Embase®，MEDLINE®,并于7月4日检索了国家卫生服务经济评价数据库，2022年确定慢性粒细胞白血病的经济学评价。还搜索了卫生技术评估网站和主要会议记录。包括比较慢性粒细胞白血病慢性期成年患者治疗方案的经济学评估。使用Drummond的检查表评估研究的质量。
检索到符合资格标准的47项研究和16项健康技术评估。大多数是成本效用分析（23项研究和11项卫生技术评估），来自美国（n=15）和中国（n=7）。27项研究和6项健康技术评估仅包括慢性期慢性粒细胞白血病患者。大多数模型都有马尔可夫结构，一年到一生的时间范围，和1个月的周期长度。通常评估的治疗方法是各种酪氨酸激酶抑制剂(伊马替尼，尼洛替尼,达沙替尼,博舒替尼,和普纳替尼)和其他干预措施，如干扰素-α，羟基脲,和同种异体干细胞移植.
在新诊断的慢性粒细胞白血病患者中，伊马替尼方案具有成本效益，主要是由于仿制药的可用性。对于对伊马替尼耐药或不耐受的患者，尼罗替尼和达沙替尼作为二线药物通常具有成本效益。尽管在更好地表征一线和二线慢性粒细胞白血病治疗的成本效益方面取得了进展，缺乏已发表的三线治疗的成本-效果研究增加了与后期治疗线的经济学评估相关的不确定性.
Embase®，MEDLINE®,并于7月4日检索了国家卫生服务经济评价数据库，2022年确定慢性粒细胞白血病的经济学评价。还搜索了卫生技术评估网站和主要会议记录。包括比较慢性粒细胞白血病慢性期成年患者治疗方案的经济学评估。使用Drummond的检查表评估研究的质量。
检索到符合资格标准的47项研究和16项健康技术评估。大多数是成本效用分析（23项研究和11项卫生技术评估），来自美国（n=15）和中国（n=7）。27项研究和6项健康技术评估仅包括慢性期慢性粒细胞白血病患者。大多数模型都有马尔可夫结构，一年到一生的时间范围，和1个月的周期长度。通常评估的治疗方法是各种酪氨酸激酶抑制剂(伊马替尼，尼洛替尼,达沙替尼,博舒替尼,和普纳替尼)和其他干预措施，如干扰素-α，羟基脲,和同种异体干细胞移植.
在新诊断的慢性粒细胞白血病患者中，伊马替尼方案具有成本效益，主要是由于仿制药的可用性。对于对伊马替尼耐药或不耐受的患者，尼罗替尼和达沙替尼作为二线药物通常具有成本效益。尽管在更好地表征一线和二线慢性粒细胞白血病治疗的成本效益方面取得了进展，缺乏已发表的三线治疗的成本-效果研究增加了与后期治疗线的经济学评估相关的不确定性.
