对新药和治疗方法的机构优先设定:质量系统审查
Daniel E Wang1, Maram Hassanein2, Yasmeen Razvi3,4
1Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
International journal of health policy and management
|April 15, 2024
概括
医疗机构需要更好的指导来为高成本药物提供资金,特别是用于罕见疾病和儿童. 本次审查确定了有效的资源分配和决策流程的关键主题.
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
- 制药政策 制药政策
背景情况:
- 缺乏明确的指导制度表格管理和高成本药物的融资.
- 需要有结构的方法来分配资源,特别是对于儿科和罕见疾病的人群.
研究的目的:
- 评估机构对高成本疗法资源配置的方法.
- 确定高成本药物的决策框架,重点关注弱势群体.
主要方法:
- 使用Embase和MEDLINE进行系统的文献搜索,用于决策研究.
- 基于简单多种属性评级技术 (SMART) 的纳入标准.
- 使用30个主题框架和反射主题分析 (QSR NVivo 12) 提取数据.
主要成果:
- 分析了168项研究;只有2%专注于儿科,12%专注于成人.
- 高成本疗法和罕见/孤儿药物分别在19%和23%的研究中被讨论.
- 出现了五个关键主题:机构战略,实质性标准,程序性考虑,指导原则和运营活动,以及儿科/罕见疾病的类别.
结论:
- 新药成本不断上升,需要在医院层面做出强有力的,基于证据的,道德的医疗技术资金决策.
- 确定的主题和实践可以指导对高成本药物的机构资金的批判性评估.
- 突出了为儿科和罕见病人群提供资金的机会和挑战.
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