Application of Cost-Utility Analysis in Health Area of China:a Systematic Review / 中国药房

ABSTRACT

OBJECTIVE:To evaluate the application of cost-utility analysis in health area of China in recent year. METH-ODSFrom CNKI,Wanfang and VIP database,settingcost utilityorcost-utilityastitleorkeyword,related literatures were retrieved during Jan. 2011-Dec. 2015,with subject field ofmedical science and technologyin CNKI,medical sciencein Wanfang database,clinical medicineChinese medicinepreclinical medicinepreventive medicine hygieneorpharmacyin VIP. The comprehensive evaluation involved research design,research perspective,cost measurement,utility index and measure-ment method,cost-utility analysis index,discount and sensitivity analysis. RESULTS:A total of 31 literatures meeting inclusion cri-teria were selected,including 12 prospective studies,9 retrospective studies,9 Markov model studies,1 mixed study. Thirteen lit-eratures worked in medical institutions. Seven literatures explicitly mentioned research perspective;most literatures only measured direct cost(19 literatures)and adopted QALY as utility index(27 literatures). Twenty eight literatures described measurement meth-od of utility index(direct measurement,indirect measurement or literature method)in detail. More than half(16 literatures)analyzed cost-utility by using cost-utility ratio(CUR);7 literatures adopted incremental cost-utility ratio(ICUR)and 6 literatures adopted both CUR and ICUR. Five literatures used the threshold of ICUR. Eleven literatures described discount,and the majority was Markov mod-el study. Sensitivity analysis was conducted in 16 literatures,among which 11 literatures adopted single factor analysis. The most com-monly involved influential factor was cost,followed by utility value and discount rate. CONCLUSIONS:Cost-utility analysis has been widely used in China,but the quality and normalization of studies have much room for improvement. Learning more experiences from international researches can help to promote the quality of domestic studies,guide the practice of clinical rational use of drugs and sup-port the government decision-making process and medical insurance payment in the future.