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1、中国循证医学杂志2005年第5卷第11期·833·Cost2effectivenessofTreatmentofChronicHepatitisBinChina:ASystematicReview12131SUNXin,YANGHuan,WANGLi,EwaOrlewska,LIYou2ping1.ChineseEvidence2BasedMedicineCenter,WestChinaHospital,SichuanUniversity,Chengdu610041,China;2.CenterforDrugE
2、valuation,StateFoodandDrugAdministration,China;3.CenterforPharmacoeconomics,Warsaw,Poland【Abstract】ObjectiveTocriticallyappraiseandsystematicallyreviewetheeconomicevaluationsofallalternativeinterventionsforhepatitisBinChina.MethodsWesearchedMEDLINEandthefour
3、largestChineseelectronicdatabas2es.Thereferencesofeligiblestudieswerealsoscreened.Economicevaluationsofanytype,whichstudiedinterventionsforhepatitisB,wereeligibleforinclusion.A252itemqualitychecklistmodifiedfromaBMJchecklistwasusedtoappraisethequalityofstudi
4、es.Theoverallqualityscorewascalculatedagainst100pointstoindicatetheriskofbias.Qualityappraisalanddataextractionwereconductedbytwoindependentreviewers.ResultsNineteenfulleconomicevaluationsandtwocoststudieswereincludedofwhichfourteenstudieswerescored2544point
5、s,andsevenscored4561points.Moststudiesadequatelydocumentedeffectivenessofinterventions.However,thecostsofinterventionswerenotwellreportedinover50%ofstudies.Manystudiesinadequatelyconducteddataanalysis,particularinsensitivityanalysisanddiscounting.Tenstudiesc
6、omparedlamivudinewithinterferonorconventionaltherapyfor12year(or62month)effects,whichindicatedthatlamivudinewasgenerallycost2effective.Threeevaluationsstudied302yearoutcomesofinterferoncomparedwithcon2ventionaltherapy,whichsuggestedthatinterferonusuallysaved
7、additionalcostsandyearsoflife.Anotherthreestudiescom2paredinterferonwithlessfrequentlyusedantiviralagents,howeverthecomparativecost2effectivenessvaried.Twocoststud2iesshowedthetotalcostsandthepercentageofmedicalcostsincreasedrapidlyinproportiontodiseasesever
8、ity.ConclusionsOfalternativeinterventions,lamivudineiscosteffectiveforshort2termeffects.Interferonissuperiortoconventionalther2apyforlong2termoutcomes.However,thelong2termeconomicoutcomescannotb