Hansen R W
CPJ. 1986 Jun;119(6):318-20, 323-5.
The cost of illness includes not only the funds required to treat illness, but also the effect on the patient's quality of life. Recent concern about rising health costs have focused on the direct expenditures without noting that the cost of illness in terms of mortality and morbidity has declined significantly. Pharmaceuticals have played a major role in reducing the total cost of illness. Several studies of the cost-effectiveness of past introductions of vaccines and pharmaceuticals reveal large cost savings. Although the focus of most studies has been on major advances, the continuing process of less dramatic therapeutic improvements has significantly trimmed the cost of illness. Cost-benefit studies of new drugs or changes in drug use, while more difficult to perform, make it possible to influence the selection of therapy. Since pharmaceuticals represent less than 10% of total treatment costs, reduction in the cost of pharmaceutical products can only have a minor impact on the total cost of illness. Pharmaceuticals can reduce the cost of illness by providing alternative therapies that reduce direct treatment cost or improve the public health.
疾病成本不仅包括治疗疾病所需的资金，还包括对患者生活质量的影响。近期对不断上升的医疗成本的关注主要集中在直接支出上，却未注意到在死亡率和发病率方面的疾病成本已显著下降。药物在降低疾病总成本方面发挥了重要作用。几项关于过去引入疫苗和药物的成本效益研究显示出大幅节省成本的情况。尽管大多数研究的重点是重大进展，但不太显著的治疗改进的持续过程也显著降低了疾病成本。对新药或药物使用变化进行成本效益研究虽然更难开展，但有助于影响治疗方案的选择。由于药品在总治疗成本中所占比例不到10%，药品成本的降低对疾病总成本的影响只能是微小的。药品可以通过提供替代疗法来降低疾病成本，这些替代疗法要么降低直接治疗成本，要么改善公众健康。
