对直接方法的系统审查,以引起需求侧成本效益值:对低收入和中等收入国家的影响
Anh Nu Vu1, Minh Van Hoang2, Lars Lindholm1
1Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
PloS one
|February 8, 2024
概括
本系统性审查探讨了每个质量调整寿命年 (QALY) 的支付意愿 (WTP) 的方法. 它确定了影响WTP值的关键因素,并为低收入和中等收入国家 (LMICs) 提供了建议.
科学领域:
- 卫生经济学 卫生经济学
- 系统审查是系统的审查.
- 支付意愿 (WTP) 诱导方式
背景情况:
- 关于成本效益值的现有文献评论往往缺乏系统的方法.
- 对质量调整生命年 (WTP/QALY) 支付意愿的直接诱导方法的深入研究是有限的.
- 了解WTP/QALY对于医疗保健的资源配置至关重要,特别是在低收入和中等收入国家 (LMICs).
研究的目的:
- 描述各种直接方法来获得WTP/QALY.
- 确定影响WTP/QALY值的重要因素.
- 检查WTP/QALY与人均GDP之间的关系,为LMICs提供可行的方法建议.
主要方法:
- 在七个数据库中使用直接方法估计WTP/QALY的研究进行了系统审查 (截止时间为2022年3月).
- 使用CPI和PPP指数将货币价值转换为2021年国际美元 (i$).
- 采用贝叶斯平均模型来评估影响因素,并根据经验证据和资源限制为LMIC方法建议制定了标准.
主要成果:
- 包括来自12,196个识别记录的64篇文章,揭示了WTP/QALY方法和值的广泛差异.
- 中位数WTP/QALY为16,647.6美元,人均国内生产总值的中位数WTP/QALY为0.53.
- 确定了11个有影响力的因素,离散选择实验方法显示100%的后置概率;大多数国家WTP/QALY低于人均GDP的1倍.
结论:
- 导出WTP/QALY的方法有很大差异,离散选择实验具有很大的影响.
- 在许多国家,WTP/QALY值往往低于人均GDP的1倍.
- 为考虑WTP/QALY估计研究的LMIC提供了基本原则,承认资源限制.
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