了解国家卫生和护理卓越研究所严重性溢价:探索其实施及其对决策和患者获取的影响
Martin W Njoroge1, Matthew Walton1, Robert Hodgson1
1Centre for Reviews and Dissemination, University of York, York, England, UK.
概括
国家卫生和护理卓越研究所 (NICE) 的新严重性修饰器有利于瘤学,但比以前的生命终端 (EoL) 溢价更难实现. 这种变化可能会导致对医疗技术的更负面建议.
科学领域:
- 卫生经济学 卫生经济学
- 卫生技术评估 卫生技术评估
- 监管科学是一种监管科学.
背景情况:
- 美国国家卫生和护理卓越研究所 (NICE) 曾经使用终生保费 (EoL) 来调整成本效益值.
- 一个新的严重性修改器取代了EoL溢价,影响了NICE对医疗技术评估 (TA) 的决策过程.
研究的目的:
- 评估NICE新的严重性修改器对未来建议的影响.
- 分析新修改器与过去的EoL溢价在历史的TA中如何相比.
主要方法:
- 2020年1月至2022年12月期间发布的NICE TAs的审查.
- 生成总结统计数据,以评估严重程度变量对过去决策的假设影响.
主要成果:
- 57%的评估符合基于严重程度的质量调整寿命年 (QALY) 乘数的条件,而获得EoL溢价的比例为33%.
- 瘤学指标比非瘤学指标有4.04倍的可能性符合严重性修饰者的条件.
- 历史上91%的EOL症状符合新的严重性标准,这表明继续优先考虑.
结论:
- 新的严重性修饰器主要有利于瘤学,类似于EoL溢价.
- 修改器更严格,较少的评估达到更高的门,可能需要制造商降低价格.
- 这种转变可能会增加NICE对健康技术的负面建议的可能性.
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