重建医疗技术评估中的价值拼图:实用性审查,以确定哪些建模方法可以考虑额外的价值元素
Jeffrey M Muir1, Amruta Radhakrishnan1, Andreas Freitag2
1Cytel Inc., Toronto, ON, Canada.
Frontiers in pharmacology
|July 31, 2023
概括
在医疗技术评估 (HTA) 中,传统的成本效益分析 (CEA) 是有限的. 本综述探讨了将更广泛的社会和患者价值观纳入HTA的方法,以加强对新疗法的决策.
科学领域:
- 卫生经济学 卫生经济学
- 卫生技术评估 卫生技术评估
- 决策科学 决策科学 决策科学
背景情况:
- 成本效益分析 (CEA) 是医疗技术评估 (HTA) 中用于评估新疗法的标准工具.
- 传统的CEA主要关注临床和经济价值,往往忽视了更广泛的社会和以患者为中心的方面.
- 越来越需要将更全面的价值理解纳入HTA.
研究的目的:
- 审查最近的建模方法,通过将额外的价值元素集成到HTA中来扩展传统的CEA.
- 确定和分析将社会价值观和健康公平纳入新卫生技术评估的方法.
- 评估这些扩展方法为HTA决策提供信息的潜力.
主要方法:
- 进行了务实的文献综述,重点关注2012年至2022年间发表的文章.
- 搜索发现了关于CEA的报告研究,其中包括超出临床和成本效益估计的价值方面.
- 审查中包括了13篇符合条件的文章,分析了各种扩展建模技术.
主要成果:
- 扩展的CEA方法主要侧重于整合社会价值观和健康公平.
- 审查的方法包括CEA的修改 (例如,分布式,增强式,扩展式CEA) 和多标准决策分析.
- 增强CEA显示出显著的潜力,因为它能够适应质量价值方面以及对HTA机构的熟悉性.
结论:
- 将额外的价值元素纳入HTA的方法已经存在并正在发展.
- 扩展的CEA方法可以提供对新技术的更全面的评估.
- 整合更广泛的价值考虑可以通过完善决策过程来改善患者获得创新医疗技术的机会.
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