一个综合风险调整的成本效益 (GRACE) 经济模型,用于测量延迟神经障碍干预的价值
Jason Shafrin1, Jaehong Kim1, Jacob Fajnor1
1FTI Consulting, 350 S. Grand Ave. Suite 3000, Los Angeles, CA 90071, United States.
概括
纳入患者的风险偏好和严重程度调整显著增加神经治疗的健康经济价值. 传统的成本效益分析可能会低估这些针对行动障碍的干预措施.
科学领域:
- 健康经济学
- 神经学
- 决策分析
背景情况:
- 神经系统疾病往往导致运动障碍,需要有效的治疗.
- 评估治疗的经济价值对于医疗保健决策至关重要.
- 传统的成本效益分析 (CEA) 可能无法完全捕捉患者特有的因素.
研究的目的:
- 量化患者风险偏好和严重程度调整对假设神经治疗的经济价值的影响.
- 将一个通用和风险调整的成本效益 (GRACE) 模型与传统的CEA进行比较.
主要方法:
- 开发了五种状态的马尔科夫模型,以评估推测中的治疗方法,延缓运动障碍的进展.
- 使用美国人口风险厌恶估计的GRACE模型.
- 使用风险回避和严重性调整后的净货币收益 (RASA-NMB) 来衡量治疗价值.
主要成果:
- GRACE提高了对健康效益的估值 (1.358个GRA-QALY对比1.199个QALY) 和支付意愿 (109656美元/GRA-QALY对比10万美元/QALY).
- 与传统CEA ($249,311) 相比,RASA-NMB与GRACE ($278,324) 的价格高出11.6%.
- 结果显示对风险回避估计和患者实用功能的敏感性.
结论:
- 在神经病学中首次应用的GRACE模型提高了假设治疗的经济价值评估.
- GRACE建议传统的CEA可能会低估神经动力障碍的治疗方法.
- 考虑风险偏好和风险严重程度可以提供更全面的经济评估.
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