Comparison and selection of application methods of meta-analysis results in economic evaluations_Chinese Journal of Evidence-Based Medicine

Authors：

GUAN Xin ^# , LI Hongchao ^# , YAO Jiaqi , LIANG Wenyan ,  MA Aixia

School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, P.R.China;

Corresponding author：

MA Aixia, Email: ma86128@sina.com

Keywords：

Meta-analysis; Cost-effectiveness analysis; Decision tree model; Method application

DOI：

10.7507/1672-2531.201807133

Video：

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ObjectivesTo compare the common application methods of meta-analysis results used in economic evaluations so as to provide reference and suggestions for similar economic evaluations in future.MethodsFour methods were used to calculate the effectiveness deriving from meta-analysis of omeprazole and esomeprazole in the treatment of peptic ulcer, then substituted into the decision tree model to perform cost-effectiveness analysis.ResultsMethod 1 used the risk difference as the incremental effectiveness. The ICER was ￥2 420, and the equal probability point of the cost-effectiveness acceptability curve (CEAC) in the probability sensitivity analysis was approximately ￥2 600. Method 2 used the effective rate of the study group in high-quality literatures as the benchmark, calculated the effective rate of the control group according to the RR. The ICER was ￥2 016, and the equal probability point of the CEAC was approximately￥2 000. Method 3 was based on the effective rate of the control group in high-quality literatures to calculate the effective rate of the study group according to RR. The ICER was ￥2 420 and the equal probability point of the CEAC was approximately￥2 200; Method 4 used literature weights to calculate the effectiveness, the ICER is ￥2 420, and the equal probability point of the CEAC was about ￥2 400.ConclusionsThe results of the four methods share little difference, and the sensitivity analysis results show that the base case analysis results are more robust. However, in the application process, method 1 lacks specific effectiveness of the two groups and underestimate the variation range of the effectiveness difference when one-way sensitivity analysis was performed. Relevant assumptions are further required to limit the possibility of effectiveness calculated greater than 1 in sensitivity analysis among method 2 and 3. Comprehensively, method 4 can be recommended in the economic evaluations for fewer defects of calculating effectiveness.

Citation： GUAN Xin, LI Hongchao, YAO Jiaqi, LIANG Wenyan, MA Aixia. Comparison and selection of application methods of meta-analysis results in economic evaluations. Chinese Journal of Evidence-Based Medicine, 2018, 18(11): 1224-1231. doi: 10.7507/1672-2531.201807133 Copy

1.	张天嵩, 钟文昭, 李博. 实用循证医学方法学(第 2 版). 长沙: 中南大学出版社, 2014.
2.	陈耀龙, 李幼平, 杜亮, 等. 医学研究中证据分级和推荐强度的演进. 中国循证医学杂志, 2008, 8(2): 127-133.
3.	刘强, 李洪超, 马爱霞. 基于决策树模型对我国中重度抑郁症临床常用药物治疗方案选择的成本-效果分析. 中国循证医学杂志, 2016, 16(6): 628-634.
4.	Ali SA, Donahue RM, Qureshi H, et al. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis, 2009, 13(1): 9-19.
5.	曾宪涛, 冷卫东, 郭毅, 等. Meta 分析系列之一: Meta 分析的类型. 中国循证心血管医学杂志, 2012, 4(1): 3-5.
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7.	邓丽清, 吴明东, 劳海忠, 等. 质子泵抑制剂埃索美拉唑三联疗法在十二指肠溃疡中的疗效观察. 河北医学, 2009, 15(2): 186-188.
8.	徐玉玲, 孙春林. 埃索美拉唑三联疗法治疗 Hp 阳性十二指肠溃疡的疗效观察. 中国现代医生, 2008, (21): 143-144.
9.	旷历琼, 巴合达娜提, 李悟. 埃索美拉唑三联与奥美拉唑三联治疗 Hp 阳性十二指肠溃疡的对比研究. 现代医药卫生, 2007, (17): 2541-2542.
10.	陈元鸿, 王婉梅, 王皓, 等. 埃索美拉唑三联与奥美拉唑三联疗法治疗 Hp 阳性十二指肠溃疡对比研究. 第一军医大学学报, 2005, (8): 1045-1047.
11.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.1.0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
12.	Tulassay Z, Kryszewski A, Dite P, et al. One week of treatment with esomeprazole-based triple therapy eradicates Helicobacter pylori and heals patients with duodenal ulcer disease. Eur J Gastroenterol Hepatol, 2001, 13(12): 1457-1465.
13.	欧阳颖, 王志凤, 江雪梅. 埃索美拉唑与奥美拉唑治疗十二指肠溃疡的疗效对比. 新疆医科大学学报, 2006, (3): 207-209.
14.	王云霄, 曹玉, 时萍. 埃索美拉唑三联疗法治疗十二指肠球部溃疡疗效分析. 山东医药, 2007, (16): 38-39.
15.	颜开华, 朱明艳, 胡林, 等. 埃索美拉唑三联与奥美拉唑三联治疗 HP 阳性十二指肠溃疡的临床对比研究. 中国临床新医学, 2008, (S1): 34-36.
16.	张秋敏, 张雷, 王建刚. 埃索美拉唑治疗消化性溃疡的临床研究. 中国药师, 2008, (4): 442-443.
17.	史美娟, 赵换. 埃索美拉唑对幽门螺杆菌阳性的十二指肠球部溃疡患者的疗效分析. 山西医药杂志(下半月刊), 2010, 39(9): 822-823.
18.	彭家先, 曹观新. 埃索美拉唑治疗 HP 感染消化性溃疡 60 例疗效观察. 中国医药指南, 2011, 9(29): 266-267.
19.	于博坤. 阿莫西林、克拉霉素、埃索美拉唑联合治疗消化性溃疡疗效观察. 吉林医学, 2012, 33(9): 1872.
20.	黄治国, 苏汝开. 埃索美拉唑三联疗法治疗幽门螺杆菌阳性十二指肠溃疡 50 例疗效观察. 中国美容医学, 2012, 21(12): 259-260.
21.	常振红, 张建强. 埃索美拉唑三联疗法治疗幽门螺杆菌阳性十二指肠溃疡的疗效观察. 临床合理用药杂志, 2012, 5(4): 62-63.
22.	白扬. 比较埃索美拉唑三联与奥美拉唑三联疗法治疗幽门螺杆菌阳性十二指肠球部溃疡的临床疗效. 北方药学, 2017, 14(5): 94-95.
23.	Wu B, Dong B, Xu Y, et al. Economic evaluation of first-line treatments for metastatic renal cell carcinoma: a cost-effectiveness analysis in a health resource-limited setting. PLoS One, 2012, 7(3): e32530.

1. 张天嵩, 钟文昭, 李博. 实用循证医学方法学(第 2 版). 长沙: 中南大学出版社, 2014.
2. 陈耀龙, 李幼平, 杜亮, 等. 医学研究中证据分级和推荐强度的演进. 中国循证医学杂志, 2008, 8(2): 127-133.
3. 刘强, 李洪超, 马爱霞. 基于决策树模型对我国中重度抑郁症临床常用药物治疗方案选择的成本-效果分析. 中国循证医学杂志, 2016, 16(6): 628-634.
4. Ali SA, Donahue RM, Qureshi H, et al. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis, 2009, 13(1): 9-19.
5. 曾宪涛, 冷卫东, 郭毅, 等. Meta 分析系列之一: Meta 分析的类型. 中国循证心血管医学杂志, 2012, 4(1): 3-5.
6. 刘国恩. 中国药物经济学评价指南及导读(2015 版). 北京: 科学出版社, 2015: 205.
7. 邓丽清, 吴明东, 劳海忠, 等. 质子泵抑制剂埃索美拉唑三联疗法在十二指肠溃疡中的疗效观察. 河北医学, 2009, 15(2): 186-188.
8. 徐玉玲, 孙春林. 埃索美拉唑三联疗法治疗 Hp 阳性十二指肠溃疡的疗效观察. 中国现代医生, 2008, (21): 143-144.
9. 旷历琼, 巴合达娜提, 李悟. 埃索美拉唑三联与奥美拉唑三联治疗 Hp 阳性十二指肠溃疡的对比研究. 现代医药卫生, 2007, (17): 2541-2542.
10. 陈元鸿, 王婉梅, 王皓, 等. 埃索美拉唑三联与奥美拉唑三联疗法治疗 Hp 阳性十二指肠溃疡对比研究. 第一军医大学学报, 2005, (8): 1045-1047.
11. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.1.0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
12. Tulassay Z, Kryszewski A, Dite P, et al. One week of treatment with esomeprazole-based triple therapy eradicates Helicobacter pylori and heals patients with duodenal ulcer disease. Eur J Gastroenterol Hepatol, 2001, 13(12): 1457-1465.
13. 欧阳颖, 王志凤, 江雪梅. 埃索美拉唑与奥美拉唑治疗十二指肠溃疡的疗效对比. 新疆医科大学学报, 2006, (3): 207-209.
14. 王云霄, 曹玉, 时萍. 埃索美拉唑三联疗法治疗十二指肠球部溃疡疗效分析. 山东医药, 2007, (16): 38-39.
15. 颜开华, 朱明艳, 胡林, 等. 埃索美拉唑三联与奥美拉唑三联治疗 HP 阳性十二指肠溃疡的临床对比研究. 中国临床新医学, 2008, (S1): 34-36.
16. 张秋敏, 张雷, 王建刚. 埃索美拉唑治疗消化性溃疡的临床研究. 中国药师, 2008, (4): 442-443.
17. 史美娟, 赵换. 埃索美拉唑对幽门螺杆菌阳性的十二指肠球部溃疡患者的疗效分析. 山西医药杂志(下半月刊), 2010, 39(9): 822-823.
18. 彭家先, 曹观新. 埃索美拉唑治疗 HP 感染消化性溃疡 60 例疗效观察. 中国医药指南, 2011, 9(29): 266-267.
19. 于博坤. 阿莫西林、克拉霉素、埃索美拉唑联合治疗消化性溃疡疗效观察. 吉林医学, 2012, 33(9): 1872.
20. 黄治国, 苏汝开. 埃索美拉唑三联疗法治疗幽门螺杆菌阳性十二指肠溃疡 50 例疗效观察. 中国美容医学, 2012, 21(12): 259-260.
21. 常振红, 张建强. 埃索美拉唑三联疗法治疗幽门螺杆菌阳性十二指肠溃疡的疗效观察. 临床合理用药杂志, 2012, 5(4): 62-63.
22. 白扬. 比较埃索美拉唑三联与奥美拉唑三联疗法治疗幽门螺杆菌阳性十二指肠球部溃疡的临床疗效. 北方药学, 2017, 14(5): 94-95.
23. Wu B, Dong B, Xu Y, et al. Economic evaluation of first-line treatments for metastatic renal cell carcinoma: a cost-effectiveness analysis in a health resource-limited setting. PLoS One, 2012, 7(3): e32530.

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