关于ICER定价和成本效益值的最佳水平的理论:一个讨价还价的方法
Mikel Berdud1, Jimena Ferraro2,3, Adrian Towse1
1Office of Health Economics (OHE), London, United Kingdom.
Frontiers in health services
|September 11, 2023
概括
医疗技术评估 (HTA) 使用成本效益值 (CET) 来决定新药补偿. 我们的模型表明,根据谈判权调整CET可以提高社会效率和创新供应.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 创新经济学的创新经济学
背景情况:
- 医疗技术评估 (HTA) 和增量成本效益比率 (ICER) 指导全球药品报销决策.
- 成本效益值 (CET) 是用于HTA的关键基准,用于金钱价值评估.
- 现有的模型往往忽视了研发成本的复杂性和制药市场的讨价还价能力.
研究的目的:
- 开发制药市场的一般模型,分析CET与健康和经济价值的分布之间的关系.
- 将沉没的研发成本,讨价还价能力和不均的研发成本分布纳入分析.
- 在不同的市场条件下确定社会有效的CET.
主要方法:
- 开发了一个一般的药品市场模型.
- 包括研发 (R&D) 成本作为开发商的沉没成本.
- 纳入使用纳什讨价还价解决方案来模拟付款人的权力.
- 分析了非均的研发成本分配对创新供应的影响.
主要成果:
- 在某些谈判权力和研发成本的场景中,高于供应端CET的CET可能是社会效率的.
- 谈判权力的分布显著影响了最佳的CET.
- 研发成本分布不均会影响创新供应.
结论:
- 决策者应该考虑可调整的CET水平或对ICER相对于CET的灵活解释,考虑到谈判权力.
- 需要进一步研究谈判力量对创新的影响.
- 调查研发投资反应 (创新的弹性) 和专利到期前后的动态是至关重要的.
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