背景:免疫检查点阻断(ICB)疗法治疗肺鳞状细胞癌(LSCC)的药物经济学存在差异。然而,没有相应的综述研究充分讨论了ICB治疗LSCC的成本效益.本文的目的是系统地回顾和评估所有可用的ICB用于LSCC的药物经济学研究。
方法:纳入标准基于人群,干预,比较器,结果,和研究设计。到2023年6月进行了电子搜索,并使用了以下数据库:PubMed,EMBASE,科克伦图书馆,和WebofScience。搜索关键词包括\'癌\',非小细胞肺,\'免疫治疗\',和“经济学”,医疗\'。主要结果是LSCC患者ICB治疗的成本-效果分析。Drummond清单用于评估纳入药物经济学研究的研究设计中的质量问题和可能的偏见。
结果:这篇综述检索了15篇关于ICB治疗LSCC的经济学评价的文章。在对15项研究进行定性审查后,我们的结论是,nivolumab作为单药治疗比单纯化疗更具成本效益.在联合方案中,pembrolizumab联合化疗似乎是目前最具成本效益的选择,但是对于拥有LSCC的中国付款人来说,局部开发的治疗方法,如sintilimab或toripalimab与化疗联合使用,更具成本效益。
结论:纳入经济评价在研究设计和结果方面具有异质性,这只能支持定性合成。因此,本文的结果需要谨慎对待。对于中国市场,而不是进口药物,当地开发的ICB疗法可能的成本-效果应该是未来研究的重点.
BACKGROUND: There are differences in the pharmacoeconomics of Immune checkpoint blocking (ICB) therapies for the treatment of lung squamous cell carcinoma (LSCC). However, no corresponding
review studies have fully discussed the cost-effectiveness of ICBs in treating LSCC. The aim of this paper is to systematically
review and evaluate all available pharmacoeconomic studies of ICBs for LSCC.
METHODS: The inclusion criteria were based on the population, intervention, comparator, outcomes, and study designs. An electronic search was conducted by June 2023, and the following databases were used: PubMed, EMBASE, Cochrane Library, and Web of Science. Search keywords included \'Carcinoma\', Non-Small-Cell Lung\', \'Immunotherapy\', and \'Economics, Medical\'. The primary outcome was the cost-effectiveness analysis of ICB therapy in LSCC patients. Drummond Checklist was used to assess quality problems and possible bias in the study design of included pharmacoeconomic studies.
RESULTS: This
review searched 15 articles on the economic evaluation of ICB treatment for LSCC. After a qualitative
review of 15 studies, we concluded that nivolumab is more cost-effective as a monotherapy than chemotherapy alone. In the combination regimen, pembrolizumab combined with chemotherapy appears to be the most cost-effective option at present, but for Chinese payers with LSCC, locally developed treatments such as
sintilimab or toripalimab in combination with chemotherapy are more cost-effective.
CONCLUSIONS: The inclusion of economic evaluation has heterogeneity in research design and outcomes, which can only support qualitative synthesis. Therefore, The results of this paper need to be treated with caution. For the Chinese market, instead of imported drugs, the possible cost-effectiveness of locally developed ICB therapies should be the focus of future research.