A systematic review of pharmacoeconomic studies of non-infectious uveitis

YANG Jing; LU Yu-qiong; DAI Zhan-jing; MAO Xin; ZHANG Wan-jie; LU Yun; CHANG Feng

doi:10.3969/j.issn.1003-3734.2024.18.014

Abstract：Objective:To conduct a systematic review of pharmacoeconomic studies of noninfectious uveitis(NIU).Methods:CNKI,WanFang Data,VIP,PubMed,Cochrane Library,Web of Science,EBSCO databases,and the websites of HTA institutions in various countries were searched to collect pharmacoeconomic studies related to NIU from database inception to April 2023.Two reviewers independently screened the literature,extracted data,and evaluated the quality of the included studies,followed by a qualitative analysis.Results:A total of five studies were included.In terms of methodology analysis,four of them were Markov model-based cost-utility analysis,differing in model state setting,model assumptions,subgroup analysis,and so on.Clinical efficacy data were all from RCTs.The utility data were mainly derived from RCT measurement results and the mapping values of visual function questionnaire data.The costs were mainly direct medical costs.In terms of economic results,adalimumab injection was less cost-effective compared with limited current practice(LCP),while dexamethasone intravitreal implant would be more cost-effective compared with LCP in the UK.Fluocinolone acetonide intravitreal implant was considered to be more cost-effective compared with LCP in the UK context,while the opposite was true in the US.Conclusion:At present,the economic evaluation results of new drugs for NIU treatment vary by drug category and national context.It is recommended that patient heterogeneity,frequency of implantations,patient remission,the occurrence of blindness,and so on should be considered to construct a robust evaluation model and formulate appropriate assumptions in China.Additionally,due to the absence of head-to-head clinical trials,indirect treatment comparison methods should be employed to minimize bias,and social perspective analysis should be supplemented to comprehensively assess the social value of drugs.