ÁºÎÄÑæÂí°®Ï¼
ÖйúÒ©¿Æ´óѧ¹ú¼ÊÒ½Ò©ÉÌѧԺ
Ä¿µÄ¶ÔÖ±½Ó¿¹²¡¶¾Ò©ÎDAAs£©ÖÎÁƱûÐͲ¡¶¾ÐÔ¸ÎÑ×µÄÒ©Îï¾¼ÃѧÆÀ¼Û½øÐÐ×ÛÊö£¬ÒÔÆÚΪÏà¹Ø¾ö²ßÌṩÒÀ¾Ý¡£·½·¨Í¨¹ýÖÐÎļ°Ó¢ÎÄÊý¾Ý¿â¼ìË÷DAAsÖÎÁƱûÐͲ¡¶¾ÐÔ¸ÎÑ×µÄÒ©Îï¾¼ÃѧÆÀ¼ÛÏà¹ØÎÄÏ×£¬¶Ô¸÷Ïî¾¼ÃѧÆÀ¼ÛµÄ»ù±¾Çé¿ö¡¢Êý¾Ý¼°½á¹û½øÐÐ×ÛÊö¡£½á¹û¹²ÄÉÈë11ƪÔÚÃÀ¹ú¡¢µÂ¹ú¡¢¼ÓÄôó¡¢ÖйúµÈ¿ªÕ¹µÄÑо¿¡£²»Í¬¹ú¼Ò¼äÓÉÓÚ¾¼Ã·¢Õ¹Ë®Æ½µÈµÄ²îÒ죬ʹÓÃDAAsÖÎÁƱûÐͲ¡¶¾ÐÔ¸ÎÑ׵ijɱ¾Ò²²»Ïàͬ¡£µ«DAAsÒ©ÎïÓ봫ͳ¾ÛÒÒ¶þ´¼¸ÉÈÅËØÁªºÏÀû°ÍΤÁÖ£¨PR£©ÁÆ·¨±È½Ï¸ü¾ß¾¼ÃÐÔ¡£½áÂÛÄ¿Ç°¹ØÓÚÊг¡ÉϱûÐͲ¡¶¾ÐÔ¸ÎÑ×ÖÎÓúÂʽϸߵÄÖ÷Á÷Ö±½Ó¿¹²¡¶¾Ò©ÎïÖ®¼ä£¬ÓÉÓÚÖÎÁƵĻùÒòÐͲ»Í¬£¬ÎÒ¹ú±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼ÕßÓ¦¸ù¾Ý×ÔÉíµÄ¼²²¡Çé¿ö¼°¾¼ÃÄÜÁ¦Ñ¡Ôñ×îÊʺÏ×Ô¼ºµÄÒ©Æ·¡£
Ö±½Ó¿¹²¡¶¾Ò©Î±ûÐͲ¡¶¾ÐÔ¸ÎÑ×£»¾¼ÃѧÆÀ¼Û
±ûÐͲ¡¶¾ÐÔ¸ÎÑ×ÊÇÓɱûÐ͸ÎÑײ¡¶¾£¨HepatitisCvirus,HCV£©¸ÐȾÒýÆð£¬Ö÷Ҫͨ¹ýÎü¶¾¡¢Õë´ÌµÈ·½Ê½´«²¥¡£ÓÉÓÚÉÐδÑз¢³öÖÎÁƱûÐͲ¡¶¾ÐÔ¸ÎÑ×µÄÒßÃ磬Òò´ËÄ¿Ç°Éв»ÄÜͨ¹ý½ÓÖÖ·½Ê½½øÐÐÓÐЧԤ·À¡£±ûÐͲ¡¶¾ÐÔ¸ÎÑ׳ÊÈ«ÇòÐÔÁ÷ÐÐÇ÷ÊÆ£¬²»Í¬ÄêÁä¡¢ÖÖ×å¡¢ÐÔ±ðÈËȺ¾ù¶ÔHCVÒ׸С£HCV¸ÐȾ·ÖΪ¼±ÐÔ¸ÐȾÓëÂýÐÔ¸ÐȾÁ½À࣬ÆäÖÐ55%¡«85%HCV¸ÐȾ»áת±ä³ÉÂýÐÔ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×[1]¡£20Äêºó¸ÎÓ²»¯·¢ÉúÂÊΪ5%¡«15%£¬¸ÎÓ²»¯Ê§´ú³¥·¢ÉúÂÊΪ3%¡«4%£¬¸Î°©Îª2%¡«4%[2]¡£Ò»µ©·¢Éú¸ÎÓ²»¯£¬»¼Õß10ÄêÉú´æÂÊԼΪ80%£¬Èô³öÏÖʧ´ú³¥Çé¿ö£¬Éú´æÂʽ«Ï½µÖÁ25%£¬¸Î°©Õï¶ÏºóµÚ1ÄêÄڵIJ¡ËÀÂÊԼΪ33%[3]¡£¾Ý¡¶ÄêÈ«Çò¸ÎÑ×±¨¸æ¡·ÏÔʾ£¬È«ÇòÔ¼ÍòÈ˸ÐȾHCV£¬ÆäÖÐÔÚÖйúHCV¸ÐȾ»¼ÕßԼΪÍòÈË[4]¡£Í¬Ê±£¬ÎÀ¼Æί¼²¿ØÖÐÐÄÄêÈ«¹ú·¨¶¨´«È¾²¡µ÷²é±¨¸æÏÔʾ£¬Äê±ûÐͲ¡¶¾ÐÔ¸ÎÑ×·¢²¡ÈËÊýԼΪ20.69ÍòÀý£¬²¡ËÀÊýΪÈË£¬Ã¿10ÍòÀý»¼ÕßÖÐÔ¼15Àý¸ÐȾÁËHCV£¬Æ䲡ËÀԼΪ0.%[5]£¬»ù±¾ÓëÄê³Öƽ[6]¡£
ÔÚÖ±½Ó¿¹²¡¶¾Ò©ÎDirect-actingantivirals,DAAs£©ÉÏÊÐÇ°£¬ÔÚ¹ú¼ÊÉÏÖÎÁƱûÐͲ¡¶¾ÐÔ¸ÎÑ׵ıê×¼·½°¸ÊǾÛÒÒ¶þ´¼¸ÉÈÅËØÁªºÏÀû°ÍΤÁÖ£¨PRÁÆ·¨£©£¬µ«Æä´æÔÚÖÎÓúÂʵ͡¢²»Á¼·´Ó¦¶à¡¢ÄÍÊÜÐÔ²î[7]µÈÎÊÌâ¡£×ÔÄêDAAsÒ©ÎïÎÊÊÀÒÔÀ´£¬±ûÐͲ¡¶¾ÐÔ¸ÎÑ×ÖÎÁÆ¿çÈëÁËн׶Ρ£DAAsÒ©Îïͨ¹ýÖ±½Ó×÷ÓÃÓÚHCVµ°°×ø¡¢RNA¾ÛºÏøµÈ²¡¶¾¸´ÖƵÄλµãÀ´Çå³ýHCV£¬ÖÎÓúÂÊ¿É´ï90%ÒÔÉÏ£¬Õë¶ÔÿÖÖÌض¨»ùÒòÐÍ£¬ÉõÖÁ¿É½Ó½ü%[8]¡£´«Í³PRÁÆ·¨ÐèÒª²ÉȡעÉ䷽ʽ£¬¶ø´ó²¿·ÖDAAsÒ©ÎïÖ»Ðè¿Ú·þ12Öܱã¿É´ïµ½È¬Óú״̬£¬ÒѳÉΪĿǰ¹ú¼ÊÉÏÍƼöµÄÖÎÁƱûÐͲ¡¶¾ÐÔ¸ÎÑ×µÄÊ×Ñ¡ÁÆ·¨¡£ÔÚÎÒ¹ú±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼ÕßÖ÷ÒªÒÔ1bÐͺÍ2aÐÍΪÖ÷£¬ÆäÖÐ1bÐÍÕ¼56.8%[9]£¬Òò´Ë£¬±¾Ñо¿Ñ¡È¡Ä¿Ç°¹ú¼ÊÉÏÖÎÁÆ1ÐͱûÐͲ¡¶¾ÐÔ¸ÎÑ×µÄÐÂÒ»´úDAAsÒ©Îï×÷ΪÑо¿¶ÔÏó£¬Ö÷Òª°üÀ¨ViekiraPak£¨3DÁÆ·¨£©¡¢¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬¡¢ÒÁ¿Â³ɳ¡¢°¬¶û°ÍΤ¸ñÀÈðƬ¡¢´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁÕâÎåÀà¡£±¾Ñо¿¾ÍÒÔÉÏÎåÀàÖ÷Á÷DAAsÒ©ÎïÖÎÁƱûÐͲ¡¶¾ÐÔ¸ÎÑ×µÄÒ©Îï¾¼ÃѧÆÀ¼ÛÎÄÏ×½øÐÐÕûÀíÓë·ÖÎö£¬ÒÔΪÎÒ¹ú±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼ÕßÓÃÒ©ÌṩÏà¹Ø²Î¿¼¡£
1×ÊÁÏÓë·½·¨1.1ÎÄÏ×¼ìË÷
ÔÚÖйúÆÚ¿¯È«ÎÄÊý¾Ý¿â¡¢ÖÐÎÄÆÚ¿¯È«ÎÄÊý¾Ý¿â¡¢Íò·½Êý¾Ý֪ʶ·þÎñƽ̨µÈÖÐÎÄÊý¾Ý¿â²ÉÓÃÖ÷Ìâ´ÊºÍ¹Ø¼ü´Ê½øÐмìË÷£¬¼ìË÷´Ê°üÀ¨Ö±½Ó¿¹²¡¶¾Ò©Îï¡¢±ûÐͲ¡¶¾ÐÔ¸ÎÑס¢Ò©Îï¾¼ÃѧÆÀ¼Û¡¢³É±¾-Ч¹û¡¢³É±¾-ЧÒæ¡¢³É±¾-ЧÓá£ÔÚPubMed¡¢ScienceDirect¡¢SpringerLink¡¢ElsevierµÈÓ¢ÎÄÊý¾Ý¿âÖмìË÷Ó¢ÎÄÎÄÏ×£¬²ÉÓá°Thematicwords¡±ºÍ¡°title/abstract¡±½øÐмìË÷£¬¼ìË÷´Ê°üÀ¨hepatitisc¡¢pharmaceuticaleconomics¡¢economicevaluations¡¢costeffectiveness¡¢costutility¡¢costbenefit¡¢directantiviralagents¡£¼ìË÷ʱ¼äÏÞ¶¨ÎªÄê1ÔÂ1ÈÕÖÁÄê3ÔÂ31ÈÕ¡£
1.2ÄÉÈëÓëÅųý±ê×¼
1.2.1ÄÉÈë±ê×¼
¢ÙÑо¿Éè¼Æ£º²ÉÓûù±¾Ò©Îï¾¼ÃѧÆÀ¼ÛÀàÐÍ£¬°üÀ¨³É±¾-Ч¹û·ÖÎö£¨cost-effectivenessanalysis,CEA£©¡¢³É±¾-ЧÓ÷ÖÎö£¨cost-utilityanalysis,CUA£©ºÍ³É±¾-ЧÒæ·ÖÎö£¨cost-benefitanalysis,CBA£©¡£¢ÚÄ¿±êÈËȺ£º1ÐÍÂýÐÔ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߣ¬°é»ò²»°é¸ÎÓ²»¯¡£¢Û¸ÉÔ¤´ëÊ©£º»¼Õß²ÉÓÃÄ¿Ç°ÔÚ¹úÍâÒÑÉÏÊÐÇÒÁÙ´²ÁÆЧ½Ï¸ßµÄÐÂÒ»´úDAAsÒ©ÎïÖÎÁÆ£¬Ö÷Òª°üÀ¨¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬¡¢ÒÁ¿Â³ɳ¡¢°¬¶û°ÍΤ¸ñÀÈðΤƬÔó±Ø´ï¡¢´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁ°ÙÁ¢ÔóºÍËÙάÆÕ¡¢ViekiraPak¼°´«Í³PRÁÆ·¨¡£¢Ü½á¾ÖÖ¸±ê£ºÔöÁ¿³É±¾-Ч¹û±È£¨incrementalcost-effectivenessratios,ICER£©¡£
1.2.2Åųý±ê×¼
¢Ù×ÛÊöÎÄÏס£¢Ú¾¼ÃѧÆÀ¼ÛЧ¹ûÖ¸±êÑ¡È¡²»ÕýÈ·¡£¢ÛDAAsÒ©ÎïÁÙ´²ÁÆЧ±È½Ï¡£¢ÜÖظ´·¢±íÎÄÏס£
1.3ÄÉÈëÎÄÏ×
¼ìË÷¹²µÃµ½ÎÄÏ×ƪ£¬ÊÖ¹¤Åųýƪ£¬¶ÔÊ£ÓàµÄ22ƪÎÄÏ×ÔĶÁÈ«ÎÄ£¬É¸Ñ¡ºó¹²µÃµ½ÖصãÎÄÏ×11ƪ[10-20]¡£ÎÄÏ×¼ìË÷Çé¿ö¼ûͼ1¡£
2½á¹û2.1ÄÉÈëÎÄÏ×»ù±¾Çé¿ö
¼û±í1¡£
2.2ÎÄÏ×·ÖÎö½á¹û
?ChhatwalµÈ[10]ÒÔ¸¶·Ñ·½½Ç¶È¶Ô²ÉÓø´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÖÎÁƵijɱ¾-Ч¹û½øÐÐÁË·ÖÎö¡£Í¨¹ý½¨Á¢MarkovÄ£ÐÍÄ£ÄâÁÙ´²ÉÏÂýÐÔ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߵļ²²¡×ª¹é¹ý³Ì¡£Ä£ÐÍÖж¨ÒåÁË7ÖÖ½¡¿µ×´Ì¬£ºÎÞÏËά»¯¡¢Çá¶È¸ÎÏËά»¯¡¢ÏÔÖø¸ÎÏËά»¯¡¢½øÕ¹ÆÚ¸ÎÏËά»¯¡¢¸ÎÓ²»¯¡¢¸Î°©¼°²¡ËÀ¡£Ä£ÐÍÖÜÆÚΪ1ÖÜ£¬Ñо¿Ê±ÏÞΪÖÕÉí¡£±¾Ñо¿½«´«Í³µÄPRÁÆ·¨×÷Ϊ¶ÔÕÕ·½°¸£¬ÒÔQALYsÒÔ¼°5ÄêµÄÒ©Îï³É±¾×÷Ϊ²ú³öÖ¸±ê¡£½á¹û±íÃ÷£¬ÓëPR·½°¸Ïà±È£¬»ùÒò1ÐͳõÖκ;ÖÎÎÞ¸ÎÓ²»¯»¼ÕßÒÔ¼°°é¸ÎÓ²»¯³õÖκ;Öλ¼ÕßµÄICER·Ö±ðÊÇ$/QALY¡¢$/QALY¡¢$/QALYºÍ$/QALY¡£ÈôÒÔ000ÃÀÔª×÷Ϊ»¼ÕßÒâÔ¸Ö§¸¶µÄãÐÖµ£¬83%³õÖλ¼ÕߺÍ81%¾Öλ¼Õß²ÉÓø´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÖÎÁÆ·½°¸¾ßÓгɱ¾-Ч¹ûÓÅÊÆ¡£Òò´Ë£¬¶ÔÓڴ󲿷ֱûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߣ¬¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬±ÈPR·½°¸¸ü¾¼Ã¡£
?StahmeyerµÈ[11]²ÉÓÃMarkovÄ£ÐÍÆÀ¹ÀµÂ¹ú»ùÒò1ÐÍ»¼Õß½ÓÊܸ´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÖÎÁƵij¤Æڳɱ¾-Ч¹û¡£±¾Ñо¿ÒԵ¹úÒ½ÁƱ£½¡ÏµÍ³½Ç¶ÈÕ¹¿ª£¬Í¬Ê±²ÉÈ¡3%µÄÌùÏÖÂÊ¡£½á¹û±íÃ÷£¬ÔÚ³õÖÎÎÞ¸ÎÓ²»¯»¼ÕßÖУ¬Ó븴·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬±È½Ï£¬3DÁÆ·¨ºÍPRÁÆ·¨µÄICER·Ö±ðΪ€/QALYºÍ€/QALY£»ÔÚ³õÖΰé¸ÎÓ²»¯»¼ÕßÖУ¬Óë3DÁÆ·¨Ïà±È£¬¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬¾ßÓоø¶ÔÓÅÊÆ£¬ICERΪ€/QALY£»ÔÚ¾ÖÎÎÞ¸ÎÓ²»¯»¼ÕßÖУ¬Ó븴·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬Ïà±È£¬3DÁÆ·¨¾ßÓоø¶ÔÓÅÊÆ£¬ICERΪ€/QALY£»ÔÚ¾Öΰé¸ÎÓ²»¯»¼ÕßÖУ¬3DÁÆ·¨ºÍPRÁÆ·¨Ïà½ÏÓÚ¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬µÄICER·Ö±ðΪ€/QALYºÍ€/QALY¡£
?ChenµÈ[12]ΪÁËÆÀ¹À12Öܸ´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÖÎÁÆ·½°¸ºÍ48ÖܾÛÒÒ¶þ´¼¸ÉÈÅËØÁªºÏÀû°ÍΤÁÖÖÎÁÆ·½°¸µÄ¾¼ÃÐÔ£¬Ñ¡È¡ÁËMarkovÄ£ÐÍÀ´Ä£ÄâÖйú»ùÒò1bÐͱûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߵļ²²¡½øÕ¹¹ý³Ì¡£×÷ÕßÑ¡È¡ÁËÖйú¶«²¿¡¢Î÷²¿¡¢±±Ò½ÔºÊÕ¼¯µ½´ú±í³ÖÐø²¡¶¾Ó¦´ðÂÊ£¨SVR£©ºÍÖ±½ÓÒ½ÁƳɱ¾Êý¾Ý¡£Í¬Ê±Í¨¹ýµ¥ÒòËØÃô¸ÐÐÔ·ÖÎöÒÔ¼°¸ÅÂÊÃô¸ÐÐÔ·ÖÎöÀ´ÆÀ¹À²ÎÊýµÄ²»È·¶¨ÐÔ¡£½á¹ûÏÔʾ£¬²»Í¬¾¼ÃÇøµÄ¹úÄÚÉú²ú×ÜÖµ£¨GDP£©ÓÐËù²»Í¬£¬ÆäICERÒ²ÓÐËù²»Í¬£¬Òò´Ë»¹ÐèÒª¸ù¾Ý²»Í¬µØÇøGDPÀ´Åжϸ´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÊÇ·ñ¾ßÓо¼ÃÐÔ¡£ÒÔ¶«²¿µØÇøΪÀý£¬³õÖÎÎÞ¸ÎÓ²»¯ºÍÓиÎÓ²»¯ÒÔ¼°¾ÖÎÎÞ¸ÎÓ²»¯ºÍÓиÎÓ²»¯»¼ÕßµÄICER·Ö±ðÊÇ¡¢¡¢¡¢ÃÀÔª/QALY¡£¸ù¾ÝÊÀ½çÎÀÉú×éÖ¯£¨WHO£©Ëù¹æ¶¨µÄ3±¶È˾ùGDPΪãÐÖµµÄÉÏÏÞ£¬¶«²¿µØÇøµÄÈ˾ùGDPΪÃÀÔª£¬Òò´ËÔÚ¶«²¿µØÇø³õÖÎÎÞ¸ÎÓ²»¯»¼Õß²»¾ß¾¼ÃÐÔ£¬¶ø³õÖΰé¸ÎÓ²»¯¡¢¾Öΰé»ò²»°é¸ÎÓ²»¯»¼Õß¾ù¾ßÓгɱ¾-Ч¹ûÓÅÊÆ¡£
?AlavianµÈ[13]²ÉÓóɱ¾-ЧÓÃÆÀ¼Û·½·¨¶ÔÄêPR¡¢PRÁªºÏË÷·Ç²¼Î¤¼°¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬Õâ3ÖÖÖÎÁÆ·½°¸ÖÎÁÆÒÁÀÊ»ùÒò1ÐͱûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õß¾¼ÃÐÔ½øÐÐÁË·ÖÎö¡£Í¬Ê±Í¨¹ýÒÑ·¢±íÎÄÏס¢×¨¼Ò·Ã̸ºÍÒ½ÁƼǼµÈ;¾¶ÊÕ¼¯QALYsºÍ³É±¾Êý¾Ý¡£Ñо¿½á¹û±íÃ÷£¬Ë÷·Ç²¼Î¤ÁªºÏPRÁÆ·¨Ïà½ÏÓÚPRÁÆ·¨³É±¾¸üµÍ£¬Í¬Ê±Ëù»ñµÃµÄQALY¸ü¸ß£¬µ«Ó븴·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬Ïà±È£¬Æä³É±¾¸üµÍµÄͬʱËù»ñµÃµÄЧÓÃÒ²¸üµÍ¡£³É±¾-Ч¹û¿É½ÓÊÜÇúÏßÒ²±íÃ÷£¬ÔÚãÐÖµµÍÓÚÃÀԪʱ£¬85.7%¡«91.7%Êý¾Ý±íÃ÷Ë÷·Ç²¼Î¤ÁªºÏPRÁÆ·¨¸ü¾ß¾¼ÃÐÔ¡£
?WongµÈ[14]ÒÔ¼ÓÄôóÊ¡ÎÀÉú²¿½Ç¶È£¬¶ÔÂýÐÔ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×ÖÎÁÆ·½°¸½øÐгɱ¾-ЧÓ÷ÖÎö¡£Í¨¹ý¹¹½¨MarkovÄ£ÐÍÀ´±È½Ï¶àÖÖ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×ÖÎÁÆ·½°¸¼äµÄ¾¼ÃÐÔ¡£½á¹û±íÃ÷£¬ÔÚ»ùÒò1ÐͳõÖλ¼ÕßÖУ¬ÓëPRÁÆ·¨Ïà±È£¬3DÁÆ·¨ºÍ¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÖÎÁÆÎÞ¸ÎÓ²»¯»¼ÕßµÄICER·Ö±ðΪ$/QALYºÍ$/QALY£¬¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÖÎÁÆ°é¸ÎÓ²»¯»¼ÕßµÄICERΪ$/QALY£»ÔÚ»ùÒò1Ð;Öλ¼ÕßÖУ¬ÓëPRÁÆ·¨Ïà±È£¬3DÁÆ·¨ÖÎÁÆÎÞ¸ÎÓ²»¯»¼ÕßµÄICERΪ$/QALY£¬¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÁªºÏÀû°ÍΤÁÖµÄICERΪ$/QALY¡£ÔÚ$ãÐÖµÄÚ£¬3DÁÆ·¨Ó븴·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÓëPRÁÆ·¨Ïà±È¾ù¾ßÓгɱ¾-ЧÓÃÓÅÊÆ¡£
?ChidiµÈ[15]¹¹½¨ÁËÒÔ1ÄêΪÖÜÆÚµÄÂí¶û¿Æ·ò½×¶Îת»¯Ä£ÐÍÆÀ¹À²»Í¬ÖÎÁƲßÂÔÓÃÓÚ60Ëê³õÖαûÐͲ¡¶¾ÐÔ¸ÎÑ×»ùÒò1ÐÍÍËÎé¾üÈ˵ľ¼ÃÐÔ¡£Ñ¡È¡3%ΪÄêÌùÏÖÂÊ¡£½«¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ºÍ3DÁÆ·¨ÓÃÓÚÖÎÁÆ5ÖÖ»¼Õߣº¢Ù´¦ÓÚÈκν׶εĻ¼Õߣ»¢Ú¸ÎÓ²»¯»¼Õߣ»¢Û3ÆÚ¸ÎÏËά»¯»ò¸ÎÓ²»¯»¼Õߣ»¢Ü¸ÎÓ²»¯¾¹ý1ÄêÖÎÁƺóתΪ1¡«3ÆÚ¸ÎÏËά»¯»¼Õߣ»¢Ý3ÆÚ¸ÎÏËά»¯»ò¸ÎÓ²»¯»¼Õß¾¹ý1ÄêÖÎÁƺóתΪÎÞÏËά»¯»ò1¡«2ÆÚÏËά»¯£¬»¹¶ÔË÷·Ç²¼Î¤ÁªºÏÎ÷ßäƥΤÒÔ¼°Ë÷·Ç²¼Î¤ÁªºÏPRÁÆ·¨ÕâÁ½ÖÖÖÎÁÆ·½Ê½½øÐÐÁ˱Ƚϡ£½á¹ûÏÔʾ£¬Ê¹ÓÃ3DÁÆ·¨ÖÎÁÆ´¦ÓÚÈκν׶εıûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õß×î¾ß¾¼ÃÐÔ¡£Í¬Ê±¸ÅÂÊÃô¸ÐÐÔ½á¹û»¹±íÃ÷µ±ãÐÖµ·Ö±ðΪ$/QALYºÍ$000/QALYʱ£¬3DÁÆ·¨·Ö±ðÓÐ70%ºÍ65%µÄ¸ÅÂʱȸ´·½À³µÏÅÁΤË÷·Ç²¼Î¤ÁÆ·¨¸ü¾ß³É±¾-Ч¹ûÓÅÊÆ¡£
?ZhangµÈ[16]ͨ¹ý½¨Á¢MarkovÄ£ÐÍÀ´¼ÆËã5ÖÖ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×ÖÎÁÆ·½°¸µÄ³É±¾ÓëQALY¡£¶ÔÓÚ»ùÒò1ÐÍ»¼Õߣ¬×÷Õß·Ö±ð±È½ÏÁË5ÖÖDAAs·½°¸£º¢Ù¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ÖÎÁÆ12ÖÜ£»¢Ú3DÁÆ·¨£»¢ÛË÷·Ç²¼Î¤+PR£»¢ÜË÷·Ç²¼Î¤+Î÷ßäƥΤ£»¢ÝÌØÀƥΤ+PRÖÎÁÆ12ÖÜ+PRÔÙÖÎÁÆ12¡«24ÖÜ¡£½á¹ûÏÔʾ£¬ÓÉÓڳɱ¾½Ï¸ß£¬ÓëË÷·Ç²¼Î¤Ïà¹ØµÄÁªºÏÓÃÒ©·½°¸¾ù²»¾ß¾¼ÃÐÔ£¬Ö»Óе±Ë÷·Ç²¼Î¤µÄ¼Û¸ñϽµ30%²ÅÓпÉÄܸıä½á¹û¡£Òò´Ë£¬ÔÚ»ùÒò1ÐÍÎÞ¸ÎÓ²»¯»¼ÕßÖУ¬3DÁÆ·¨×î¾ß¾¼ÃÐÔ£»¶øÔÚ°é¸ÎÓ²»¯»¼ÕßÖУ¬¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤·½°¸×î¾ß¾¼ÃÐÔ¡£
?CormanµÈ[17]ÒÔ¸¶·Ñ·½½Ç¶ÈÑо¿°¬¶û°ÍΤ¸ñÀÈðΤÖÎÁÆ»ùÒò1ÐͱûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߵijɱ¾-ЧÓ㬲¢°´ÕÕ»¼ÕߵĻùÒòÐÍ¡¢ÖÎÁÆÀúÊ·¡¢¸ÎÓ²»¯×´Ì¬½«Æä·ÖΪ8ÀࡣΪ´Ë£¬×÷Õß½«¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬¡¢ÒÁ¿Â³ɳÒÔ¼°3DÁÆ·¨×÷Ϊ¶ÔÕÕ·½°¸²¢Í¨¹ý¹¹½¨Âí¶û¿Æ·òÄ£ÐÍÆÀ¹ÀÕâ4ÖÖÖÎÁÆ·½°¸µÄ¾¼ÃÐÔ¡£½á¹û±íÃ÷Ó븴·½À³µÏÅÁΤË÷·Ç²¼Î¤Ïà±È£¬ÔÚËùÓл¼ÕßÖУ¬°¬¶û°ÍΤ¸ñÀÈðΤ¾ù´¦ÓÚ¾ø¶ÔÓÅÊÆ¡£ÔÚ»ùÒò1aÐÍÎÞ¸ÎÓ²»¯»¼ÕߺͻùÒò1bÐ͸ÎÓ²»¯»¼ÕßÖУ¬°¬¶û°ÍΤ¸ñÀÈðΤ·½°¸Ïà½ÏÓÚÆäËû3ÖÖ·½°¸¸ü¾ß¾¼ÃÐÔ¡£ÔÚ»ùÒò1aÐ͸ÎÓ²»¯»¼ÕßÖУ¬ÒÁ¿Â³ɳ½Ï¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬ºÍ3DÁÆ·¨¾¼Ã£¬ÇÒÆä¶ÔÓÚ°¬¶û°ÍΤ¸ñÀÈðΤµÄICERΪ$17.9Íò/QALY£»ÔÚËùÓеĻùÒò1aÐÍ»¼ÕߺͻùÒò1bÐͳõÖÎÎÞ¸ÎÓ²»¯»¼ÕßÖУ¬ÒÁ¿Â³ɳ±È3DÁÆ·¨ºÍ¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤Æ¬¸ü¾ß¾¼ÃÐÔ¡£ÔÚ»ùÒò1b¾Öλ¼ÕßÖУ¬3DÁÆ·¨Ïà½ÏÓÚ°¬¶û°ÍΤ¸ñÀÈðΤµÄICERΪ¼¸Ç§ÍòÃÀÔª£¬Òò´Ë£¬°¬¶û°ÍΤ¸ñÀÈðΤËäÈ»»ñµÃµÄЧÓÃÂԵͣ¬µ«Æä³É±¾È´Ã÷ÏÔµÍÓÚ3DÁÆ·¨¡£
?LuµÈ[18]ΪÁËÆÀ¹À24ÖÜ´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁÓë48ÖÜPRÁÆ·¨ÖÎÁÆÖйú»ùÒò1bÐͳõÖαûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߵľ¼ÃÐÔ£¬´ÓÒ½ÁƱ£ÏÕ¸¶·Ñ·½µÄ½Ç¶È³ö·¢¹¹½¨Âí¶û¿Æ·òÄ£ÐÍ¡£×÷ÕßÑ¡È¡ÁË00Àýƽ¾ùÄêÁäΪ44.5ËêµÄÂýÐÔ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õß½øÐÐÑо¿£¬Í¬Ê±Ê¹ÓÃ5%µÄÌùÏÖÂÊ¡£½á¹û±íÃ÷£¬¶ÔÓÚ»ùÒò1bÐͳõÖαûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߣ¬24ÖÜ´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁÓë48ÖÜPRÁÆ·¨µÄ³É±¾·Ö±ðΪ$ºÍ$£¬ËùÄܹ»»ñµÃµÄQALY·Ö±ðΪ14.63ºÍ13.34¡£Òò´Ë£¬ÓëPRÁÆ·¨Ïà±È£¬´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁ·½°¸¾ßÓоø¶Ô¾¼ÃÓÅÊÆ£¬²¢ÇÒÄܹ»½µµÍ´ú³¥ÐÔ¼°Ê§´ú³¥ÐÔ¸ÎÓ²»¯¡¢¸Î°©¼°Óë¸ÎÔàÏà¹ØÐÔ²¡ËÀµÄ·çÏÕ¡£
?MattinglyµÈ[19]ͨ¹ýÊÕ¼¯Ïà¹ØÎÄÏ×Êý¾Ý¶Ô°¬¶û°ÍΤ¸ñÀÈðΤ¡¢¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤¡¢ÒÁ¿Â³ɳ¼°3DÁÆ·¨Õâ4ÖÖÖÎÁÆ·½°¸½øÐÐÁ˳ɱ¾-Ч¹û·ÖÎö¡£½èÖúÂí¶û¿Æ·òÄ£ÐÍ£¬×÷ÕßÒÔµÚÈý·½¸¶·ÑÕ߽Ƕȷֱð·ÖÎöÁË5Äê¡¢10Äê¼°50ÄêÕâ3ÖÖÑо¿Ê±ÏÞϵľ¼ÃÐÔ¡£½á¹û±íÃ÷£¬¶ÔÓÚ»ùÒò1ÐͱûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߣ¬QALYµÄ·¶Î§Îª18.08¡«18.40£¬¶ø×ܳɱ¾Îª$¡«$¡£ÔÚ4ÖÖÖÎÁÆ·½°¸ÖУ¬°¬¶û°ÍΤ¸ñÀÈðΤÊÇ×îÓŲßÂÔ£¬Æä´ÎΪÒÁ¿Â³ɳ¡£
?ΪÁËͨ¹ý³É±¾¼°½¡¿µ²ú³ö±È½Ï¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤¼°´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁÖÎÁÆÈÕ±¾ÂýÐÔ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߵľ¼ÃÐÔ£¬WardµÈ[20]¹¹½¨ÁËÂí¶û¿Æ·òÄ£ÐͶԶþÕß½øÐÐÁ˳ɱ¾-Ч¹û·ÖÎö¡£Óë´Ëͬʱ£¬±¾ÎÄ»¹Í¨¹ý¹¹½¨Ô¤ËãÓ°Ïì·ÖÎöÄ£ÐÍÔ¤²â²»Í¬ÖÎÁÆ˳ÐòµÄ³É±¾Ó°Ïì¡£Ñо¿½á¹û±íÃ÷£¬¾¡¹Ü¶þÕßÔÚÉúÃüÄê¼°ÖÊÁ¿ÉúÃüµ÷ÕûÄê½öÏà²î0.ºÍ0.£¬µ«ÊÇÔڳɱ¾É϶þÕßÈ´Ïà²î¾Þ´ó£¬¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤·½°¸±È´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁ·½°¸³É±¾Ôö¼ÓÁ˽ü1±¶£¨$vs$£©£¬ÆäICERΪ$/QALY¡£Òò´Ë£¬ÔÚÏàËƽ¡¿µ²ú³öÏ£¬´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁ·½°¸±È¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤·½°¸¸ü¾ß¾¼ÃÐÔ¡£
3ÌÖÂÛ¾¡¹ÜDAAsÒ©ÎïµÄ¼Û¸ñÏÔÖø¸ßÓÚÒÔÍù´«Í³ÖÎÁÆ·½°¸£¬µ«ÓÉÓÚÆäÁÆЧÏÔÖø¡¢ÁƳ̶̵ÈÌص㲻һ¶¨»áµ¼ÖÂ×ÜÖÎÁƳɱ¾Æ«¸ß¡£Òò´Ë£¬±¾Ñо¿Ö÷ÒªÊÇÕë¶Ô²»Í¬DAAsÒ©ÎïÖÎÁÆÂýÐÔ±ûÐͲ¡¶¾ÐÔ¸ÎÑ׵ijɱ¾-Ч¹û»ò³É±¾-ЧÓýøÐÐ×ÛÊö¡£Ö÷Òª·¢ÏÖ£º¢ÙÔÚÄ£Ð͹¹½¨·½Ã棬±¾Ñо¿ËùÄÉÈëµÄÎÄÏ×¾ùʹÓÃÁËÂí¶û¿Æ·òÄ£ÐÍÀ´Ä£ÄâÂýÐÔ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼Õߵļ²²¡×ª¹é¹ý³Ì¡£ÎÄÏ×ÖеĻ¼Õß¾ù°´ÕÕ¸ÎÏËά»¯ÆÀ·ÖÇé¿ö£¨F0¡«F4ÆÚÖ®Ò»£©½øÈëÄ£ÐÍ£¬µ±»¼Õß»ñµÃµÄÏàÓ¦SVRÂÊʱ±íʾ»¼ÕßÒѱ»ÖÎÓú¶øÍ˳öÄ£ÐÍ¡£´¦ÓÚF0¡«F4ÆڵĻ¼Õß¾ù¿ÉÒÔÖ±½Óת»¯Îª¸ÎÓ²»¯¡¢¸Î°©»òÖ±½Ó½øÈ벡ËÀ״̬¡£µ«ÊÇÓм¸µã´ó¶àÊýÄ£Ð;ùδ¿¼Âǵ½£¬Èç91%Ä£Ð;ùûÓп¼ÂDZûÐͲ¡¶¾ÐÔ¸ÎÑ×ÖÎÁƳɹ¦ºóµÄÔÙ¸ÐȾ£¬ËùÓÐÄÉÈëµÄÎÄÏ×¾ùûÓп¼Âǵ½±ûÐͲ¡¶¾ÐÔ¸ÎÑ׵Ĵ«È¾ÐÔ¡£Òò´Ë£¬ÔÚ½ñºóµÄÄ£Ð͹¹½¨ÖпÉÒÔ¿¼ÂÇÉèÁ¢Ïà¹Ø¶¯Ì¬Ä£ÐÍÄÉÈëÓÉÓÚ±ûÐͲ¡¶¾ÐÔ¸ÎÑ×´«È¾ÐÔËù´øÀ´µÄÎÊÌâ¡£´ËÍ⣬11ƪÎÄÏ×Öй²ÓÐ9ƪÎÄÏײÉÈ¡3%ÌùÏÖÂÊ£¬ÕâЩ¹ú¼Ò°üÀ¨Öйú¡¢µÂ¹ú¼°ÃÀ¹úµÈ¡£¢ÚÔÚÊý¾Ý²É¼¯·½Ã棬ÓÉÓÚÄ¿Ç°²ÉÓÃDAAsÒ©ÎïÖÎÁÆ»¼ÕßÊýÁ¿½ÏÉÙ£¬ÎÄÏ×ÖÐËù²ÉÓõĴ󲿷ÖÊý¾ÝÀ´Ô´ÓÚÒÑ·¢±íÎÄÏ×£¬Ö»ÓÐÉÙÊý¼¸Æª[11,12,15]À´Ô´ÓÚÕæʵÊÀ½çÑо¿¼°ÁÙ´²ÊÔÑéÊý¾Ý¡£Òò´Ë£¬ÉÐÐèÒª½øÒ»²½Ñо¿·ÖÎöÆÀ¹ÀÏÖʵÊÀ½çDAAsÒ©ÎïµÄ¾¼ÃÐÔ¡£¢Û´ÓÄÉÈëÎÄÏ×Ñ¡È¡µÄ¹ú¼ÒÀ´¿´£¬8ƪÎÄÏ×Ñ¡È¡µÄÑо¿¹ú¼Ò¾ùΪ·¢´ï¹ú¼Ò£¬ÇÒÖ÷Òª¼¯ÖÐÔÚÃÀ¹úºÍÅ·ÃË¡£µ«ÊÇDAAsÒ©ÎïÔÚÓ¡¶ÈµÈһЩ¹ú¼ÒÍùÍù¼Û¸ñ¸üµÍ[21]£¬Òò´ËÈôÖйú»¼ÕßÑ¡Ôñ¹ºÂòÓ¡¶ÈµÄ·ÂÖÆÒ©£¬Æä³É±¾¿ÉÄܽÏÕâЩ¹ú¼ÒµÍ¡£¢ÜÓ봫ͳPRÁÆ·¨Ïà±È£¬DAAsÒ©ÎïÔÚÖÎÓúÂʽϸߵÄͬʱÆä³É±¾Ò²½Ï¸ß£¬µ«ÊÇ£¬ÓÉÓÚ²»Í¬¹ú¼Ò¾¼Ã·¢Õ¹Ë®Æ½µÄ²îÒ죬DAAsÒ©ÎïÊÇ·ñ¾ßÓо¼ÃÐÔÓ¦¸ù¾Ý¾ßÌå¹ú¼ÒµÄGDPµÈˮƽ¶ø¶¨¡£×ܵÄÀ´Ëµ£¬DAAsÒ©Îï±ÈPRÁÆ·¨¸ü¾¼Ã¡£¶øÔÚDAAsÒ©ÎïÖ®¼ä£¬Ïà¶ÔÓÚË÷·Ç²¼Î¤¡¢ÌØÀƥΤ¡¢Î÷ßäƥΤµÈÀÏÒ»´úDAAsÒ©Îï¶øÑÔ£¬ÐÂÒ»´úDAAsÒ©Î︴·½À³µÏÅÁΤË÷·Ç²¼Î¤¡¢ÒÁ¿Â³ɳ¡¢°¬¶û°ÍΤ¸ñÀÈðΤ¡¢3DÁÆ·¨¡¢´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁ¸ü¾ß¾¼ÃÐÔ[22]¡£Òò´Ë£¬ÔÚ¾¼Ã³ÐÊÜ·¶Î§ÄÚÍƼö»¼ÕßÑ¡ÓÃÊʺÏ×Ô¼º»ùÒòÐ͵ÄDAAsÒ©Îï¡£¢Ýͨ¹ýÃô¸ÐÐÔ·ÖÎö¿ÉÖª£¬Ä£ÐͲÎÊý¶ÔDAAsÒ©ÎïµÄ³É±¾-Ч¹û»ò³É±¾-ЧÒæÓ°Ïì½Ï´ó£¬°üÀ¨ÌùÏÖÂÊ¡¢SVRÂÊ¡¢Ò©Æ·¼Û¸ñ¡¢HCV¼²²¡×ª¹é¹ý³ÌÖеÄתÒƸÅÂʵȣ¬Ìá¸ßÕâЩ²ÎÊýµÄ׼ȷÐÔ¿ÉÒÔÔö¼ÓÄ£Ð͵Ä׼ȷÐÔ¡£
±¾Ñо¿¹²ÄÉÈë11ƪӢÎÄÎÄÏ×£¬Ïà¶ÔÓÚÖÐÎÄÎÄÏ׶øÑÔÖÊÁ¿¸ü¸ß¡£ÆäÖÐÓÐ1ƪÎÄÏ×µÄÑо¿¶ÔÏóÊÇÖйú£¬Òò¶ø¸üÄܽáºÏÖйúÈË¿ÚÌص㣬Õë¶ÔÖйú±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼ÕßµÄʵ¼ÊÇé¿ö½øÐÐÑо¿¡£Ä¿Ç°¹ØÓÚDAAsÒ©ÎïµÄ¾¼ÃѧÆÀ¼Û×ÛÊö½ÏÉÙ£¬´ó²¿·ÖΪÍâÎÄÎÄÏ×£¬¶øÎÒ¹ú¹úÄÚ¹ØÓÚÕâ·½ÃæµÄÑо¿¸üÊÇÉÙÖ®ÓÖÉÙ£¬ÇÒDAAsÒ©ÎïÄ¿Ç°»¹Î´ÕýʽÔÚÎÒ¹úÉÏÊУ¬Òò´ËÓбØÒª½øÐÐÕâ·½ÃæµÄÑо¿¡£±¾Ñо¿ÃÖ²¹Á˹úÄÚ¹ØÓÚDAAsÒ©ÎïÖÎÁƱûÐͲ¡¶¾ÐÔ¸ÎÑ×Ò©Îï¾¼ÃѧÆÀ¼ÛÎÄÏ׵IJ»×㣬²¢ÎªÎÒ¹ú±ûÐͲ¡¶¾ÐÔ¸ÎÑ×»¼ÕßÓÃÒ©ÌṩÏà¹Ø½è¼ø¡£
ͬʱ±¾Ñо¿Ò²´æÔÚ×ÅһЩ¾ÖÏÞÐÔ¡£¹úÍâ¶ÔDAAsÒ©ÎïµÄ¾¼ÃѧÆÀ¼ÛÎÄÏ×´ó¶à¶¼ÊǹØÓÚ¸´·½À³µÏÅÁΤË÷·Ç²¼Î¤ÓëPRÁÆ·¨Ö®¼äµÄ±È½Ï£¬¶ø±¾Ñо¿×ÅÖرȽÏÁ˸´·½À³µÏÅÁΤË÷·Ç²¼Î¤¡¢ÒÁ¿Â³ɳ¡¢°¬¶û°ÍΤ¸ñÀÈðΤ¡¢´ïÀËûΤºÍ°¢ÊæÈðΤ¸´·½ÖƼÁ¼°3DÁÆ·¨ÕâÎåÀàÒ©Æ·Ö®¼äµÄ¾¼ÃÐÔ£¬¶ÔÓÚË÷·Ç²¼Î¤¡¢Î÷ßäƥΤ¡¢ÌØÀƥΤµÈ·½°¸Ö»ÊÇÂÔÓÐÌá¼°¡£ÓйØÐÂÒ»´úDAAsÒ©ÎïµÄ¾¼ÃѧÆÀ¼ÛÎÄÏ×½ÏÉÙ£¬Òò´ËÉв»ÄܵóöÄÄÖÖÐÂÒ»´úDAAsÒ©Îï¸ü¾ß¾¼ÃÐÔ£¬»¼ÕßÓ¦¸ù¾Ý×ÔÉí¼²²¡Çé¿ö¡¢¾¼ÃˮƽѡÔñÊʺϵÄÒ©Æ·¡£
²Î¿¼ÎÄÏ×
[1]ChenSL,MorganTR.Thenaturalhistoryofhepatitiscvirus(HCV)infection[J].InternationalJournalofMedicalSciences,.
[2]DibonaventuraMD,YuanY,LescrauwaetB,etal.MulticountryburdenofchronichepatitisCviralinfectionamongthoseawareoftheirdiagnosis:apatientsurvey[J].PLoSOne,,9(1):e.
[3]ÍõÑÞ±ó,лö©.¡¶±ûÐ͸ÎÑ×·ÀÖÎÖ¸ÄÏ(Äê¸üаæ)¡·½â¶Á[J].ÖлªÊµÑéºÍÁÙ´²¸ÐȾ²¡ÔÓÖ¾(µç×Ó°æ),(6):1-4.
[4]WHO.Globalhepatitisreport[R]..
[5]ÖлªÈËÃñ¹²ºÍ¹úÎÀÉú²¿¼²²¡Ô¤·À¿ØÖƾÖ.ÄêÈ«¹ú·¨¶¨´«È¾²¡ÒßÇé¸Å¿ö[R].±±¾©,.
[6]ÖлªÈËÃñ¹²ºÍ¹úÎÀÉú²¿¼²²¡Ô¤·À¿ØÖƾÖ.ÄêÈ«¹ú·¨¶¨´«È¾²¡ÒßÇé¸Å¿ö[R].±±¾©,.
[7]HsuCS,KaoJH.Peginterferonalfa-2boralfa-2awithribavirinforhepatitisC[J].NEnglJMed,,(18):-.
[8]ÂíÒàÁÖ.Ö±½Ó¿¹²¡¶¾Ò©Îï(DAAs)ÖÎÁƱûÐ͸ÎÑ×µÄÑо¿ÏÖ×´[J].ÖлªÁÙ´²¸ÐȾ²¡ÔÓÖ¾,(1):8-13.
[9]³ÂºìËÉ,ñ¼Ïþ¹â,¶ÎÖÓƽ,µÈ.±ûÐ͸ÎÑ×·ÀÖÎÖ¸ÄÏ(Äê¸üаæ)[J].ÁÙ´²¸Îµ¨²¡ÔÓÖ¾,(12):-.
[10]ChhatwalJ,KanwalF,RobertsMS,etal.Cost-effectivenessandbudgetimpactofhepatitisCvirustreatmentwithsofosbuvirandledipasvirintheUnitedStates[J].AnnInternMed,,(6):-.
[11]StahmeyerJT,RossolS,LierschS,etal.Cost-Effectivenessof
TreatingHepatitisCwithSofosbuvir/LedipasvirinGermany[J].PLoSOne,,12(1):e.
[12]ChenGF,WeiL,ChenJ,etal.WillSofosbuvir/Ledipasvir(Harvoni)BeCost-EffectiveandAffordableforChinesePatientsInfectedwithHepatitisCVirus?AnEconomicAnalysisUsing
Real-WorldData[J].PLoSOne,,11(6):e.
[13]AlavianSM,NikfarS,KebriaeezadehA,etal.ACost-UtilityAnalysisofDifferentAntiviralMedicineRegimensinPatientsWithChronicHepatitisCVirusGenotype1Infection[J].IranRedCrescentMedJ,,18(11):e.
[14]WongWW,LeeKM,SinghS,etal.DrugtherapiesforchronichepatitisCinfection:acost-effectivenessanalysis[J].CMAJOpen,,5(1):97-.
[15]ChidiAP,RogalS,BryceCL,etal.Cost-effectivenessofnewantiviralregimensfortreatment-naiveU.S.veteranswithhepatitisC[J].Hepatology,,63(2):-.
[16]ZhangS,BastianND,GriffinPM.Cost-effectivenessofsofosbuvir-basedtreatmentsforchronichepatitisCintheUS[J].BMCGastroenterol,(15):98.
[17]CormanS,ElbashaEH,MichalopoulosSN,etal.Cost-UtilityofElbasvir/GrazoprevirinPatientswithChronicHepatitisCGenotype1Infection[J].ValueHealth,,20(8):-.
[18]LuY,JinX,DuanCA,etal.Cost-effectivenessofdaclatasvirplusasunaprevirforchronichepatitisCgenotype1btreatment-naivepatientsinChina[J].PLoSOne,,13(4):e.
[19]MattinglyTJ2nd,SlejkoJF,MullinsCD.HepatitisCTreatmentRegimensAreCost-Effective:ButComparedWithWhat[J].AnnPharmacother,,51(11):-.
[20]WardT,WebsterS,MishinaS,etal.AssessingtheBudgetImpactandEconomicOut±±¾©ÖÎÁÆ°×ñ°·ç×ܹ²Òª»¨¶àÉÙÇ®ºÚÁú½ÖÎÁÆ°×ñ°·çÒ½Ôº