在不确定性下测量治疗价值的两种方法:在神经病学中估计保险价值和风险偏好
Jason Shafrin1, Kyi-Sin Than2, Jacob Fajnor1
1FTI Consulting, 350 S. Grand Ave. Suite 3000, Los Angeles, CA 90071, USA.
Forum for health economics & policy
|July 15, 2025
概括
神经学治疗被传统的成本效益方法所低估. 这项研究表明,个人不喜欢风险,并愿意为延迟认知和移动障碍的治疗付出更多费用,突出显示需要风险调整分析.
科学领域:
- 卫生经济学 卫生经济学
- 神经科学是一个神经科学.
- 决策分析 决策分析
背景情况:
- 神经系统疾病导致生活质量显著下降和财务负担.
- 传统的成本效益分析可能会通过假设风险中立性来低估神经治疗.
- 对神经健康状况的风险偏好对于准确的经济评估至关重要.
研究的目的:
- 量化假设治疗延迟神经疾病的认知和身体障碍的保险价值.
- 为了测量风险偏好与神经健康状况相比,进行综合风险调整的成本效益 (GRACE) 分析.
- 通过纳入患者的风险厌恶来为经济评估提供信息.
主要方法:
- 使用多个随机阶梯设计进行了两个国家调查,以引起对假设治疗的支付意愿 (WTP).
- 保险价值计算为WTP超过风险中立的质量调整生命年 (QALY) 价值.
- 使用与健康相关的生活质量 (HRQoL) 估计和选择实验 (霍尔特和劳里方法) 来衡量风险厌恶.
主要成果:
- 认知障碍延迟治疗的WTP为646.88美元/年 (相对于260.80美元的风险中性),这意味着风险调整后的门为248,037美元/QALY.
- 受访者表现出对认知障碍的风险厌恶 (平均RRA=1.49).
- 运动障碍预防的WTP为671.35美元/年 (相对于风险中立的133.23美元),这意味着风险调整后的门为502,193美元/QALY.
- 受访者表现出对行动障碍的风险厌恶 (平均RRA=0.68).
结论:
- 个人表现出显著的愿意支付治疗缓解神经障碍的治疗费用.
- 患者在认知和移动健康状况方面不愿意冒风险.
- 将风险偏好纳入成本效益分析对于精确评估神经治疗方法至关重要.
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