健康的货币价值 - - 一个实用的决策框架,结合了公平考虑和WTP
Elizabeta Ribarić1, Ismar Velić1, Ana Bobinac2
1University of Rijeka, Faculty of Economics and Business, Center for Health Economics and Pharmacoeconomics (CHEP), Ivana Filipovića 4, 51000, Rijeka, Croatia.
概括
关于克罗地亚健康收益的货币价值的第一项研究估计,每年调整后生活质量 (QALY) 的支付意愿为17.000欧元. 诸如年龄和健康严重程度之类的股权考虑因素会影响这些值,为成本效益值提供信息.
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
- 基于价值的医疗保健
背景情况:
- 包括克罗地亚在内的中欧和东欧国家缺乏关于成本效益值的经验研究.
- 现有的基于GDP的门可能得到不充分的支持,这可能会影响医疗保健的定价和补偿.
- 需要建立由公共偏好决定的需求侧成本效益门.
研究的目的:
- 估计克罗地亚健康收益的货币价值,建立了该国第一个此类估值.
- 评估在评估健康益处时,对公平考虑的经验支持,特别是年龄和健康严重程度 (比例缺陷).
- 提出一个务实的框架,将公平融入成本效益值.
主要方法:
- 通过在线调查,采用了随机估值方法,采用了克罗地亚代表性样本 (N=1,500).
- 根据29个EQ-5D健康状况和支付表/开放式问题,每个质量调整生命年 (QALY) 的诱导支付意愿 (WTP).
- 使用参数和非参数测试,包括多线性回归,以分析数据和测试理论有效性.
主要成果:
- 据估计,克罗地亚的健康收益的货币价值为17.000欧元,相当于人均GDP的1.15倍.
- 年龄是一个重要的公平因素:儿童的WTP (14,200欧元) 比成人 (11,700-11,900欧元) 高.
- 较高的比例缺陷 (更严重) 与WTP正相关;建议的门范围高达20,308欧元,用于严重的儿科疾病.
结论:
- 经验证据对于开发中欧和东欧地区基于价值的评估框架至关重要.
- 目前依赖于没有经验支持的基于GDP的值可能会导致低于最佳的定价和报销决策.
- 该研究为基于证据的成本效益值提供了基础,其中包括公共偏好和公平.
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