我国肝癌筛查及肝病精细化管理策略的卫生经济学评价
Health Economic Evaluation of Hepatocellular Carcinoma Screening and Optimal Delicacy Management Strategies in China
谢青 1王方舟 2张力月 2曲姝丽 3吴静雅 3廖忆涵 3金春林4
作者信息
- 1. 上海交通大学医学院附属瑞金医院 上海 200025
- 2. 罗氏集团中国战略部 上海 201106
- 3. 艾昆纬卫生经济与真实世界研究 上海 200126
- 4. 上海市卫生和健康发展研究中心 上海 200031
- 折叠
摘要
目的:通过成本-效果分析,评估肝癌筛查、诊断、治疗和肝病精细化管理的健康获益和经济价值.方法:从卫生体系的视角出发,通过构建决策树-马尔可夫模型,对比肝癌风险分层筛查和长期监测随访与无筛查相比,在我国肝癌风险人群中的成本-效果.结果:对于肝癌风险人群,进行筛查与无筛查相比,具有成本-效果优势.情景分析结果显示,从40岁开始进行肝癌筛查并进行风险分层精细化随访管理,具有更高的经济性.结论:在肝癌筛查落地过程中,应提高风险人群对于肝癌筛查的参与度和依从性,纳入更先进的筛查手段,利用数字化工具提高管理效率,引入创新支付手段减轻经济负担.
Abstract
Objective:Based on the cost-effectiveness,it aimed to assess the health benefits amd economic value of screening,di-agnosis,treatment,and optimal delicacy management of liver disease in hepatocellular carcinoma(HCC)patients.Methods:A Deci-sion tree-Markov model was developed to compare the cost-effectiveness of HCC screening and long-term surveillance versus no screening in population at risk from the health care system perspective.Results:It is found that HCC screening was a cost-effective approach compared to no screening(Incremental Cost-Effectiveness Ratio[ICER]:17 790 yuan/QALY).Scenario analyses suggested that initiating HCC screening at the age of 40,as recommended by clinical guidelines,and implementing long-term surveillance based on risk stratification were more cost-effective.Conclusions:For the implementation of HCC screening programs,attention should be paid to improving participation and compliance among the population at risk,incorporating advanced screening methods,improving management efficiency with digital tools,and introducing innovative payment methods to reduce economic burden.
关键词
肝癌筛查/肝病精细化管理/成本-效果分析Key words
hepatocellular carcinoma/liver disease delicacy management/screening/cost-effectiveness引用本文复制引用
出版年
2024
NETL
NSTL
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