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应用药物经济学:文献中药物经济学数据的评估与应用

Applied pharmacoeconomics: evaluation and use of pharmacoeconomic data from the literature.

作者信息

Sanchez L A

机构信息

PE Applications Inc., Boston, MA 02108, USA.

出版信息

Am J Health Syst Pharm. 1999 Aug 15;56(16):1630-8; quiz 1638-40. doi: 10.1093/ajhp/56.16.1630.

Abstract

The evaluation and use of published pharmacoeconomic data are discussed. The pharmacoeconomic literature is a vast and powerful source of information for pharmacists and others who must make decisions about services and products. Published studies can provide data quickly and inexpensively, but they may not necessarily meet criteria for quality and may not be generalizable to a specific situation. Guidelines are available that are intended to standardize study methods, minimize potential bias, and increase the comparability and credibility of data. Before relying on a published study, decision-makers should ensure that it meets criteria related to objective, perspective, pharmacoeconomic method, design, interventions, costs, outcomes, discounting, results, sensitivity analysis, extrapolation of conclusions, and sponsorship. A sound study can be used to support decisions in such diverse areas as individual patient treatment, formulary management, drug-use guideline development, disease management initiatives, and pharmaceutical service evaluation. A decision-maker may be able to use the results by applying them at face value, employing a sensitivity analysis, performing a meta-analysis, incorporating the data into a pharmacoeconomic model, or reproducing the study on a smaller scale. The selection of an application strategy should be based on the potential impact of the decision on the quality and cost of care, with more rigorous and complex strategies reserved for more extreme impacts. Published pharmacoeconomic data can help pharmacists make better and more informed decisions about pharmaceutical services and products.

摘要

本文讨论了已发表的药物经济学数据的评估与应用。药物经济学文献是药剂师及其他必须对服务和产品做出决策的人员获取信息的丰富且强大的来源。已发表的研究能够快速且低成本地提供数据,但它们不一定符合质量标准,也可能无法推广至特定情况。现有指南旨在规范研究方法、尽量减少潜在偏倚,并提高数据的可比性和可信度。在依赖已发表的研究之前,决策者应确保其符合与目标、视角、药物经济学方法、设计、干预措施、成本、结果、贴现、结果、敏感性分析、结论外推以及资助相关的标准。一项完善的研究可用于支持在诸如个体患者治疗、处方集管理、用药指南制定、疾病管理举措以及药学服务评估等不同领域的决策。决策者或许能够通过直接应用结果、进行敏感性分析、开展荟萃分析、将数据纳入药物经济学模型或在较小规模上重复该研究来使用这些结果。应用策略的选择应基于决策对医疗质量和成本的潜在影响,对于影响更为极端的情况,则应采用更为严谨和复杂的策略。已发表的药物经济学数据可帮助药剂师就药学服务和产品做出更优且更明智的决策。

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