对新型癌症药物的优先设定决策:一个定性案例研究
D K Martin1, J L Pater, P A Singer
1Department of Health Policy, Management and Evaluation and Public Health Sciences, M5G 1L4, Ontario, Canada.
Lancet (London, England)
|December 1, 2001
概括
对新型癌症药物的优先设定涉及到比简单的权衡更复杂的因素. 临床益处是关键,但随着预算的变化和治疗成本的上升,理性发展.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 瘤学药物政策 药物政策
背景情况:
- 合法的优先设定框架强调了需要明确的决策理由的需要.
- 确定优先级的理由,特别是新型癌症治疗方法的理由,往往没有充分记录.
- 本研究探讨了支持新型癌症药物的资助决策的理由.
研究的目的:
- 描述一个负责资助新型癌症药物的委员会所使用的实际理由.
- 了解优先级设置在癌症药物资助中的实际应用.
- 确定影响这些资金决策的因素.
主要方法:
- 使用了定性案例研究方法.
- 通过分析文件,采访委员会成员和观察委员会会议来收集数据.
- 该研究的重点是癌症护理安大略省政策咨询委员会对新药资助计划的政策咨询委员会.
主要成果:
- 在三年内,分析了8个疾病领域的14种药物的决定和理由.
- 临床益处成为影响资金决策的主要因素.
- 确定优先级的理由表现出复杂性,涉及因素集群而不是简单的权衡,并随着预算变化和药物成本增加而演变.
结论:
- 对确定优先级决策的现实世界观察提供了与理论模型不同的见解.
- 了解实际的理由对于提高癌症药物资金的合法性和公平性至关重要.
- 理由的动态性强调了需要适应性优先设定流程的需要.
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