在成本效益方面不歧视的原则性方法
Darius N Lakdawalla1, Jason N Doctor2
1Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, USA. dlakdawa@usc.edu.
概括
评估处方药价值的新方法,如EVL和HYT,有缺陷和不一致. 一般化风险调整成本效益 (GRACE) 为非歧视性药物定价提供了一个微观经济上合理的替代方案.
科学领域:
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
- 卫生政策分析 卫生政策分析
背景情况:
- 美国通货膨胀减少法 (IRA) 限制了对医疗保险药品价格谈判的歧视性价值评估方法.
- 这就需要替代方法来公平地评估处方药的价值,特别是对弱势群体.
研究的目的:
- 评估拟议的非歧视性价值评估方法:获得生命年数 (EVL) 和总体健康年数 (HYT) 的等值.
- 提出一种基于微观经济原则的替代方法,用于公平的药物价值评估.
主要方法:
- 对EVL和HYT的微观经济基础的分析.
- 随着时间的推移,确定EVL和HYT决策中的不一致性.
- 开发通用风险调整成本效益 (GRACE) 作为一种拟议的替代方案.
主要成果:
- EVL和HYT缺乏强大的微观经济基础.
- 这些方法表现出不一致性,包括附加性问题,间接比较,某些群体的生存收益负值,无限制的平均收益和非凸偏好.
- 在理论上,GRACE提供了一个合理的替代方案.
结论:
- 现有的非歧视性药物价值评估方法 (EVL,HYT) 在理论上是有缺陷的,在实践中是不一致的.
- 基于健全的微观经济原则,一般化风险调整成本效益 (GRACE) 被提出为公平的处方药定价评估的优越替代方案.
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