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目的系统评价射频消融与胺碘酮比较治疗房颤的经济学价值,为临床治疗方案选择、药物遴选、药物政策制定提供参考。方法计算机检索Pub Med、The Cochrane Library、CNKI和CBM数据库,搜集国内外公开发表的射频消融与胺碘酮治疗房颤的药物经济学研究,检索时限均从2000年至2014年。由2位评价者独立筛选文献、提取资料,并评价纳入研究的方法学质量。根据临床效果、成本、增量成本效果比(ICER),评价射频消融与胺碘酮比较治疗房颤的成本-效果。结果共纳入3个研究,药物经济学评价结果显示,其ICER值分别为$7 976~$29 068、￡7 763~￡27 745和$59 194。参照相应国家的意愿支付阀值,所有纳入研究的ICER值均在该国的意愿支付范围内。结论射频消融术与胺碘酮相比治疗房颤是具有成本-效果的方案。
Objective To systematically evaluate the economic value of radiofrequency ablation and amiodarone in the treatment of atrial fibrillation, and provide reference for clinical treatment options, drug selection and drug policy making. Methods The databases of Pub Med, The Cochrane Library, CNKI and CBM were searched by computer, and the domestic and foreign published pharmacological studies on radiofrequency ablation and amiodarone in the treatment of atrial fibrillation were searched from 2000 to 2014. Two reviewers independently screened the literature, extracted data, and evaluated the quality of the methodology included in the study. The cost-effectiveness of atrial fibrillation was compared with amiodarone based on clinical outcomes, cost-benefit ratio (ICER), and radiofrequency ablation. Results A total of three studies were included. The results of the pharmacoeconomic evaluation showed that the ICER values were from $ 7 976 to $ 29 068, from £ 7 763 to £ 27 745 and from $ 59 194, respectively. The threshold was paid in the light of the willingness of the country concerned, and all ICER values included in the study were within the country’s willingness to pay. Conclusion Radiofrequency ablation is a cost-effective regimen for the treatment of atrial fibrillation compared with amiodarone.