To systematically evaluate the effectiveness, safety and economics of taurodeoxycholic acid (TUDCA) in the treatment of cholelithiasis based on the health technology assessment (HTA) method.

The HTA reports, systematic reviews, randomized controlled trials and pharmacoeconomic researches were retrieved from PubMed, Embase, Cochrane Library, CNKI and Wanfang databases, as well as the HTA organization databases and websites. A Meta-analysis or descriptive analysis on the search results were performed.

Four RCT studies and one economic study were included in this study. The literature is generally of good quality. Compared with ursodeoxycholic acid (UDCA) or placebo, after TUDCA treatment for 3 to 4 months, the apparent efficiency rate was higher than the control group [RR=3.60, 95%CI (1.56 to 8.29), P=0.003], and the effective rate was also higher than the control group [RR=5.24, 95%CI (2.67~10.26), P<0.000 01], the inefficiency rate is lower [RR=0.19, 95%CI (0.10~0.37), P<0.000 01]. Compared with UDCA, the apparent and total effective rates were slightly higher than those in the control group after 6 months of treatment with TUDCA [RR=1.54, 95%CI (0.88~2.72), P=0.13] and [RR=1.66, 95%CI (0.93~2.96), P=0.09], the treatment inefficiency was lower [RR=0.60, 95%CI (0.34~1.08), P=0.09]. TUDCA has a good safety without serious adverse reactions occurred during the treatment. For patients with non-surgical cholelithiasis, TUDCA is expensive (ΔC=3 876.08), but more effective than UDCA (ΔE=24.98%, ICER=15 504.32). Compared with the UDCA, TUDCA has an absolute economic advantage in preventing gallstone recurrence (△C=-1 742.05) and incremental output (△U=0.22 QALYs, ICER=-7 975.26 yuan/QALD).

TUDCA has good efficacy and safety in treating cholelithiasis. Compared with UDCA, TUDCA was relatively more cost-effective in treating cholelithiasis. Since only 4 studies comparing TUDCA with UDCA or placebo were included, the results of this study are at risk of bias due to the small sample size and limitations of the research methods.