神経学的状態における移動障害を遅らせる介入の価値を測定するための一般化リスク調整コスト効果 (GRACE) 経済モデル
Jason Shafrin1, Jaehong Kim1, Jacob Fajnor1
1FTI Consulting, 350 S. Grand Ave. Suite 3000, Los Angeles, CA 90071, United States.
まとめ
患者のリスク偏好と重症度調整を考慮すると 神経学的治療の健康経済的価値が著しく増加します 伝統的な費用対効果の分析では,移動障害に対するこれらの介入が過小評価される可能性があります.
科学分野:
- 健康 経済
- 神経学
- 意思決定分析
背景:
- 神経学的疾患はしばしば運動障害を引き起こし,効果的な治療が必要になります.
- 治療の経済的価値を評価することは,医療の意思決定において極めて重要です.
- 従来の費用対効果分析 (CEA) は,患者特有の要因を完全に捉えることはできません.
研究 の 目的:
- 患者のリスク偏好と重症度調整が 仮説的な神経学的治療の経済的価値に与える影響を定量化する.
- 一般化されリスク調整された費用対効果 (GRACE) モデルと伝統的なCEAを比較する.
主な方法:
- モビリティ障害の進行を遅らせる仮説的な治療法を評価するために5つの状態のマルコフモデルを開発しました.
- 米国の人口のリスク回避率を推定した GRACE モデルを実装した.
- リスク回避と重症度調整された純金利 (RASA-NMB) を用いて測定された治療価値
主要な成果:
- GRACEは,健康上の利益 (1.358 GRA-QALY vs. 1.199 QALY) と支払意向 (109,656 GRA-QALY vs. 100,000 QALY) の評価を高めました.
- RASA-NMBは,従来のCEA (249,311ドル) に比べてGRACEで11.6%高かった.
- 結果は,リスク回避の推定値と患者の有用性機能に対する感受性を示した.
結論:
- 神経学に初めて適用されたGRACEモデルは,仮説的な治療の経済的価値の評価を強化しました.
- GRACEは,従来のCEAは,神経学的移動障害の治療を過小評価する可能性があることを示唆しています.
- リスクの好みと重さを考慮すると,より包括的な経済評価が得られます.
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