ObjectivesTo systematically review the methods of pharmacoeconomic evaluation model for hepatitis C therapies and to identify shortcomings of the existing modeling research by comparing the model structure, hypothesis and methodological differences, and to provide suggestions for the construction of high-quality hepatitis C pharmacoeconomic evaluation models.MethodsPubMed, EMbase, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect relevant literatures on the pharmacoeconomic evaluation models for hepatitis C therapies from August 2014 to August 2019. Two reviewers independently screened literature, extracted data, and evaluated the quality of the included studies. Then, the data related to the model structure, methods, and assumptions were compared and summarized.ResultsMost of the 46 studies that finally included used similar modeling methods. Ignoring different modeling elements would cause overestimation or underestimation of the value of hepatitis C therapies. Model structure of all studies were similar and key parameters were from the same source. Forty-five studies measured the cost of drugs and medical cost of health status. All studies used quality-adjusted life years as the outcome and reported incremental cost-effectiveness ratio. Thirty studies conducted one-way sensitivity analysis and probability sensitivity analysis.ConclusionsThe included studies share similar methodological designs and have high quality in general. However, there are some differences and deficiencies in research perspective, model types, model assumptions and model verification. Future pharmacoeconomic evaluation model of hepatitis C therapies should report the results of the whole society, establish dynamic model to consider the impact of transmission, make half-cycle correction for long periods, consider the recurrence after cure, model liver transplantation, and verify the model.
At present, the most commonly used nucleoside (acid) anaog (NAs) treatment regimen in clinical practice cannot completely cure chronic viral hepatitis B (CHB). However, although the polyethylene glycol interferon treatment regimen is superior to the NAs regimen in terms of immune mechanism, it has the disadvantage of low hepatitis B virus DNA response rate. In recent years, the cure of CHB is being studied all over the world. Various mechanisms and drug targets are being explored, and diversified therapeutic strategies are also being used. Clinical cure of hepatitis B is possible, but it is still in the early stage, and many potential drugs and better therapeutic strategies are still being tested. This article mainly reviews the latest progress in the treatment of CHB based on the recent research achievements in direct antiviral drugs and host immunotherapy as well as the research progress in combination therapy.
From December 2022 to January 2023, 4 lung transplant recipients (3 males and 1 female, aged 52-60 years, all received transplantation less than 1 year) were hospitalized in the Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University due to COVID-19 after surgery. The clinical manifestations were mostly characterized by elevated body temperature accompanied by shortness of breath, and indicators such as heart rate, oxygen saturation, and oxygenation index could reflect the severity of the condition. The therapy was timely adjusted to immunosuppressive drugs, upgraded oxygen therapy, anti-bacterial and anti-fungal therapy, prone ventilation, general treatment, and anticoagulant therapy, depending on the situation. Finally, 3 patients were cured and discharged from hospital, and 1 died.