临床和经济审查研究所的共享储蓄方法是否会降低基于价值的价格,主要是针对最严重的疾病?
Jason Shafrin1, Shanshan Wang2, Khounish Sharma1
1Center for Healthcare Economics and Policy, FTI Consulting, Los Angeles, CA, USA.
概括
临床和经济审查研究所 (ICER) 的共享储蓄假设不成比例地影响罕见,严重和儿科疾病. 这些假设可能会对具有重大经济负担的条件的健康益处价格基准产生负面影响.
科学领域:
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
- 临床试验分析
背景情况:
- 临床和经济审查研究所 (ICER) 在其医疗技术评估中使用共享储蓄假设.
- 了解这些假设对不同疾病类别的影响对于准确的基于价值的定价至关重要.
- 最近的FDA批准提供了一个数据集来评估ICER关于新疗法的方法.
研究的目的:
- 确定最容易受到ICER共享储蓄假设影响的疾病类型.
- 分析ICER的共享储蓄方法 (50/50和15万美元的成本抵消上限) 如何影响假设疗法的估值.
- 确定这些经济模式对疾病的影响最大的特征.
主要方法:
- 提取了2019-2023年期间FDA批准的治疗方法的经济负担和疾病特征.
- 应用ICER的50/50共享储蓄和15万美元的成本抵消上限方法.
- 根据这两种方法,评估了假设治愈的可接受成本节约的差异.
- 描述性地分析与最大影响相关的疾病特征.
主要成果:
- 分享的储蓄显著降低了对血友病A,急性肝脏病和性夜间血红蛋白尿症的假设治愈的价值.
- 与负担较低的疾病相比,具有更高年负担 (≥15万美元) 的疾病表现出更早的发病,更低的预期寿命和更低的患病率.
- ICER的共享储蓄对预期寿命更短,生活质量更差,患病率更低的疾病的健康益处价格基准有更大的预测影响.
结论:
- 预计ICER的共享储蓄假设将对罕见,严重和儿科疾病的健康益处价格基准产生最严重的负面影响.
- 这些发现凸显了针对特定疾病群体的新疗法被评价的潜在差异.
- 可能需要进一步的研究来完善经济模型,以便在各种疾病类型中进行公平的估值.
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