当治疗有多种指示时,要以成本有效的方式定价治疗:不仅仅是简单的门分析
Jeremy D Goldhaber-Fiebert1, Lauren E Cipriano2
1Department of Health Policy and Center for Health Policy, Stanford School of Medicine and Freeman Spogli Institute, Stanford University, Stanford, CA, USA.
概括
当治疗有多种适用时,标准的价格值分析是不够的. 定价和报销规则对基于价值的价格分析产生重大影响,影响患者获取和制造商战略.
科学领域:
- 卫生经济学 卫生经济学
- 制药价格的制定 制药价格的制定
- 卫生技术评估 卫生技术评估
背景情况:
- 经济评估越来越多地使用价格值分析来基于价值的定价.
- 标准分析对于具有多种适应症的治疗方法是不够的.
- 定价和报销规则会影响基于价值的价格评估.
研究的目的:
- 检查指标特定的定价和报销规则如何影响基于价值的价格分析.
- 模拟制造商和付款人之间的战略互动在多种指示药物市场.
主要方法:
- 一个治疗制造商和付款者之间的两阶段游戏理论模型.
- 分析指标特定需求,制造商利最大化和付款人的支付意愿门.
- 考虑游戏变体,对定价和退款决定有不同的约束.
主要成果:
- 通过完全灵活的特定指示定价和退款,市场简化为多个单一指示分析.
- 当一个单一的价格被强加于全额或无偿的价格时,价格成为加权平均值,补贴价值较低的指示.
- 单一定价与指示特定覆盖率可以导致高价格和有限的访问,或更低的价格与更广泛的访问和消费者余.
结论:
- 对多种指示治疗的经济评估必须考虑到特定的定价和补偿条例.
- 定价和补偿的结构显著影响治疗的可访问性和整体市场价值.
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