Mason J M
Centre for Health Economics, University of York, Heslington, England.
Pharmacoeconomics. 1994 Jun;5(6):472-81. doi: 10.2165/00019053-199405060-00004.
It has become common for analysts to present the findings of cost-utility analyses in cost per quality-adjusted life-year (QALY) league tables or rankings. These purport to show the relative value-for-money of different healthcare technologies. Concomitantly, there is an increasing market for cost-effectiveness data worldwide. However, the practice of constructing league tables has drawn criticism. Claims of inappropriate comparisons, and poor and flawed methodology have been made. How should decision-makers view cost/QALY league tables? In future, published league tables will need to be more informative and thus, by necessity, complex. The principal obstacle to informing health policy-makers with economic analysis is the lack of appropriate outcome data. From this follows uncertainty as to what represents acceptable value-for-money in healthcare purchasing. Thus, the long term objective must be to obtain valid assessments of the value of current and new health service activities. It is in this context that league tables may eventually be most helpful. More immediately, a strategy is required to help decision-makers to prioritise resources rationally with incomplete information.
分析人员在质量调整生命年（QALY）成本排行榜或排名中展示成本效用分析结果已变得很常见。这些排行榜旨在显示不同医疗技术的相对性价比。与此同时，全球范围内成本效益数据的市场在不断扩大。然而，构建排行榜的做法受到了批评。有人声称存在不恰当的比较以及方法不当和有缺陷的问题。决策者应如何看待成本/QALY排行榜？未来，已发布的排行榜需要包含更多信息，因此必然会更复杂。用经济分析为卫生政策制定者提供信息的主要障碍是缺乏适当的结果数据。由此产生了在医疗保健采购中什么代表可接受的性价比的不确定性。因此，长期目标必须是对当前和新的卫生服务活动的价值进行有效的评估。正是在这种背景下，排行榜最终可能会最有帮助。更直接地说，需要一种策略来帮助决策者在信息不完整的情况下合理地对资源进行优先排序。
