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中国防痨杂志 ›› 2026, Vol. 48 ›› Issue (8): 1231-1230.doi: 10.19982/j.issn.1000-6621.20260191

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利福平耐药/耐多药结核病药物治疗的卫生经济学研究进展与展望

孙丹雨辰, 刘宇红()   

  1. 首都医科大学附属北京胸科医院/中国疾病预防控制中心结核病防治临床中心, 北京 101149
  • 收稿日期:2026-04-08 出版日期:2026-08-01 发布日期:2026-07-30
  • 通信作者: 刘宇红,Email:liuyuhong0516@126.com

Pharmacotherapy of rifampicin-resistant/multidrug-resistant tuberculosis: advances and prospects in health economic research

Sun Danyuchen, Liu Yuhong()   

  1. Clinical Center on Tuberculosis, China CDC/Beijing Chest Hospital, Capital Medical University, Beijing 101149, China
  • Received:2026-04-08 Online:2026-08-01 Published:2026-07-30
  • Contact: Liu Yuhong, Email: liuyuhong0516@126.com

摘要:

本文系统综述了利福平耐药/耐多药结核病(rifampin-resistant/multidrug-resistant tuberculosis,RR/MDR-TB)药物治疗领域的卫生经济学研究进展。通过梳理传统二线抗结核药物方案、含新药短程口服方案[如含贝达喹啉、含德拉马尼、BPaL(B:贝达喹啉;Pa:普托马尼;L:利奈唑胺)/BPaLM(M:莫西沙星)方案],以及患者管理模式(如数字化督导、社区管理)的经济学评价证据,总结了不同干预措施的成本、效果与成本效益。总体而言,含新药的短程方案在提升治疗成功率的同时,在多国情境下显示出良好的成本效益或直接成本节约优势;以患者为中心的管理模式创新亦能显著降低疾病负担。然而,现有研究在特殊人群覆盖、成本视角全面性、真实世界数据整合等方面仍存局限。未来研究应致力于构建更综合、更精准、更具转化价值的经济学评价体系,以推动RR/MDR-TB防治策略的优化与公共卫生资源的合理配置。

关键词: 抗药性, 结核, 药物疗法,联合, 经济学,医学, 综述

Abstract:

This paper systematically reviews advances in health economic research on pharmacotherapy for rifampicin-resistant/multidrug-resistant tuberculosis (RR/MDR-TB). By sorting out economic evaluation evidence concerning conventional second-line anti-TB regimens, short-course all-oral regimens containing new anti-TB drugs (including bedaquiline-containing regimens, delamanid-containing regimens, BPaL regimen (B: bedaquiline; Pa: pretomanid; L: linezolid) and BPaLM regimen (M: moxifloxacin)), as well as patient management models (such as digital directly observed treatment and community-based management), this article summarizes the costs, effectiveness and cost-effectiveness of different interventions. Overall, short-course regimens incorporating new drugs can improve treatment success rates and deliver favorable cost-effectiveness or direct cost savings in multiple national settings. Patient-centered innovative management models can also substantially reduce disease burden. Nevertheless, existing studies have limitations in coverage of special populations, comprehensiveness of cost perspectives, and integration of real-world data. Future research should strive to establish a more comprehensive, precise and translatable economic evaluation system, so as to facilitate the optimization of RR/MDR-TB prevention and treatment strategies and rational allocation of public health resources.

Key words: Drug resistance, Tuberculosis, Drug therapy, combination, Economics, medical, Review

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