OBJECTIVES: To evaluate the effectiveness, safety and economy of treprostinil in pulmonary arterial hypertension (PAH) patients using rapid health technology assessment.

METHODS: Pubmed, Embase, Web of Science, the Cochrane Library, Epistemonikos, CRD, CNKI and wanfang databases were systematically searched. Two reviewers independently identified studies, extracted data and assessed the quality of included studies. Qualitative analysis was performed.

RESULTS: A total of one HTA report, 9 systematic reviews and 5 pharmacoeconomic studies were finally included. The assessment of effectiveness showed that, compared with placebo, treprostinil could increase patients’ 6-min walk distance, reduce Brog dyspnea score, improve hemodynamic parameters (improve cardiac index, decrease pulmonary vascular resistance), but there were no significant differences in incidence of mortality and clinical deterioration. Indirect comparisons showed that, treprostinil was non-inferiority to other prostacyclin analogs. The assessment of safety showed that, compared with placebo, treprostinil could increase incidence of withdrawal from studies. However, the incidence of drug intolerance was decreased comparing with epoprostenol, and had no significant differences with iloprost or beraprost. The assessment of economy showed that, subcutaneous treprostinil was associated with improvement of cost-effectiveness than intravenous epoprostenol.

CONCLUSIONS: The effectiveness, safety and economy of treprostinil in PAH therapy are acceptable. Providers should select the prostacyclin analogs on the basis of the feature of drugs, the drug delivery system and the individual condition.