| ABSTRACT Objective: A systematic review method was used to evaluate the economics of inhaled preparations therapy in stable phase of chronic obstructive pulmonary disease. Methods:PubMed, the Cochrane Library, Embase, SinoMed, CNKI, WanFang Data and VIP database were electronically searched to collect economic evaluation of inhaled preparations in the treatment of chronic obstructive pulmonary diseasefrom inception to December 2018. Two reviewers independently screened literatures, extracted data and assessed methodological quality. Finally, we comprehensively analyzed the efficacy, cost and cost effectiveness data. Results:9 studies were included in our research, and majority of which had high quality in methodology. In reducing the incidence of acute exacerbations and improving FEV1, the inhalation of compound preparation or combined inhalation regimen was substantially better than the monotherapy inhalation regimen, but at the same time, the cost of treatment increases. Inhaling Salmeterol/Fluticasone (SALM/FUT) vs. SALM alone, ICER was $13 000 to 46 300/QALY <3 times per capita GDP, and the added cost was acceptable. Inhalation of Budesonide/Flumotorol (BUD/FORM)+ Tiotropium bromide (TIO) compared to TIO alone, for 12 weeks of treatment, ICER was 149 to avoid a severe acute exacerbation. Giving SALM/FUT+TIO for a year compared with TIO alone, ICER was CAN $145 756/QALY > $50 000/QALY threshold. Conclusion:The imitation TIO has similar efficacy to the original research variety, but it has a price advantage. Inhalation of SALM/FUT and BUD/FORM are more economical than oral bambuterol. Due to the small number of included studies and the low quality, the above conclusions need to be verified by more high quality studies. Many studies are foreign studies. Due to the different health systems and national conditions, although the research methods have reference value, the external applicability of the results is limited. |
