A systematic review of pharmacoeconomic evaluations on oral diarylquinoline-based treatment for drug-resistant tuberculosis: from high to low burden countries

<b>Introduction</b>: There is a rising global interest in the pharmacoeconomic evaluations of bedaquiline (BDQ), a novel oral diarylquinoline, for treatment of drug-resistant tuberculosis (DR-TB). <b>Areas covered</b>: This article systematically reviewed publications retrieved from Medline, American Psychological Association-Psychology information, Web of Science, Embase, Scopus, Science direct, Center for Reviews and Dissemination, and CINAHL Complete during 2010–2020 on pharmacoeconomic studies on BDQ for DR-TB treatment. Ten Markov model-based cost-effectiveness analyses identified were conducted in high (n = 4), intermediate (n = 2), and low (n = 4) TB burden countries. <b>Expert opinion</b>: The paucity of model-based health economic analyses on BDQ-containing regimens for DR-TB indicated that further pharmacoeconomic research of BDQ-based regimens, on the aspects of duration of BDQ treatment, types of DR-TB indicated, and settings of regions and health-systems, is highly warranted to inform global cost-effective use of BDQ-based regimens for DR-TB treatment.

**引言**：针对新型口服二芳基喹啉类药物贝达喹啉（bedaquiline, BDQ）治疗耐药结核病（drug-resistant tuberculosis, DR-TB）的药物经济学评价，在全球范围内的关注度正日益提升。
**研究覆盖范围**：本文系统回顾了2010-2020年间，从Medline、美国心理学会心理学信息库（American Psychological Association-Psychology information）、Web of Science、Embase、Scopus、Science direct、循证评价与传播中心（Center for Reviews and Dissemination）以及CINAHL Complete数据库中检索到的关于贝达喹啉治疗耐药结核病的药物经济学研究相关文献。本次研究共纳入10项基于马尔可夫（Markov）模型的成本-效果分析，这些研究分别在结核病负担高（n=4）、中（n=2）及低（n=4）国家开展。
**专家观点**：当前针对含贝达喹啉方案治疗耐药结核病的模型化卫生经济学分析仍较为匮乏，这提示未来需针对贝达喹啉治疗方案的多个维度开展进一步药物经济学研究，包括贝达喹啉治疗时长、适用的耐药结核病类型、不同地区及卫生系统场景等，从而为全球范围内合理、经济地使用含贝达喹啉方案治疗耐药结核病提供决策依据。