医疗辅助生殖的经济评估:一个方法论系统性审查
Astrid Van Muylder1, Thomas D'Hooghe1, Jeroen Luyten1
1Department Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium (AVM, JL); Research Group Reproductive Medicine, Department of Development and Regeneration, Organ Systems, Group Biomedical Sciences, KU Leuven (University of Leuven), Belgium (TD); Department of Obstetrics, Gynecology and Reproductive Sciences Yale School of Medicine, New Haven, CT, USA (TD); Global Medical Affairs Fertility, Research and Development, Merck Healthcare KGaA, Darmstadt, Germany (TD). The review was written at the Leuven Institute for Healthcare Policy. It was presented at the ESHRE 38th Annual Meeting (Milan 2022). The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Astrid Van Muylder and Jeroen Luyten have no conflicting interests to declare. The participation of Thomas D'Hooghe to this publication is part of his academic work; he does not see a conflict of interest as Merck KGaA was not involved in writing this article. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: We acknowledge an internal funding from KU Leuven for this study. The funding agreement ensured the authors' independence in designing the study, interpreting the data, writing, and publishing the report. The following authors are employed by the sponsor: Astrid Van Muylder and Jeroen Luyten.
医疗辅助生殖 (MAR) 的健康经济评估是复杂的. 大多数研究都侧重于短期,基于临床的每活产成本,忽略了更广泛的社会成本和结果.
科学领域:
- 卫生经济学 卫生经济学
- 生殖医学是一种生殖医学.
背景情况:
- 医疗辅助生殖 (MAR) 为健康经济评估带来了独特的挑战,因为它具有广泛的,长期的成本和多个利益相关者.
- 复杂性来自于各种各样的成本和结果,可能跨越多代人.
研究的目的:
- 在公布的 MAR 经济评估中系统地审查成本和结果.
- 将这些与不同的评估目标的健康技术评估 (HTA) 指南进行比较.
主要方法:
- 在HTA指南和主要数据库 (PubMed Central,Embase,WOS CC,CINAHL,Cochrane,HTA,NHS EED) 中进行系统搜索.
- 分析2010年至2022年期间发表的MAR经济评估.
- 数据提取的重点是包括成本和结果,与HTA建议进行比较.
主要成果:
- 确定了93个成本效益估计,主要是从临床角度 (47%) 的活产成本 (57%).
- 很少有研究采用社会观点或使用质量调整的寿命年 (QALYs) (2%).
- 更广泛的评估经常遗漏了相关的MAR成本和结果,HTA指南对几个类别缺乏明确的指导.
结论:
- 发表的MAR经济评估通常是短期的,以临床为中心的,以每活产成本为导向的.
- 综合性的,长期的,社会视角的评估,使用像成本-每QALY这样的指标是稀缺的,往往是不完整的.
- 在HTA中,需要对MAR进行进一步的方法开发,以及包括更广泛的成本和结果范围的指导.
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