Tugwell P
Department of Medicine, University of Ottawa, Ontario, Canada.
Rheumatology (Oxford). 2000 Jun;39 Suppl 1:43-7. doi: 10.1093/oxfordjournals.rheumatology.a031494.
Rheumatoid arthritis (RA) is a chronic inflammatory disease that results in progressive functional limitation, physical disability and premature death. RA extracts a considerable economic toll, particularly in terms of indirect costs related to lost productivity and premature mortality. Given these considerations, any therapy for RA that slows or prevents disability would be expected to confer economic benefit. Determination of drug efficacy does not automatically imply economic benefit, however. Establishment of economic benefit requires a rigorous analysis of both the benefits and the total costs of a given therapy The cost of drug therapy, including treatment of side-effects, currently constitutes only 15% of the total direct cost of RA, so it is important to assess other costs in any economic analysis. Common guidelines with regard to methods, units and data treatment are necessary to permit comparison of the economic benefit of different therapies within and across disease states. Such guidelines are being established for economic evaluations of medical interventions in RA. Application of these guidelines to future pharmacoeconomic studies of RA therapy will permit more accurate assessment of the economic benefit of such treatments. Given the current fiscal constraints on health care, demonstration of economic benefit will become an increasingly important factor for drug acceptance.
类风湿性关节炎(RA)是一种慢性炎症性疾病,会导致进行性功能受限、身体残疾和过早死亡。RA造成了相当大的经济损失,特别是在与生产力损失和过早死亡相关的间接成本方面。考虑到这些因素,任何减缓或预防残疾的RA治疗方法都有望带来经济效益。然而,确定药物疗效并不自动意味着具有经济效益。确定经济效益需要对特定治疗方法的益处和总成本进行严格分析。药物治疗的成本,包括副作用的治疗,目前仅占RA总直接成本的15%,因此在任何经济分析中评估其他成本都很重要。关于方法、单位和数据处理的通用指南对于比较不同疾病状态内和不同疾病状态间不同治疗方法的经济效益是必要的。目前正在为RA医疗干预的经济评估制定此类指南。将这些指南应用于未来RA治疗的药物经济学研究将能够更准确地评估此类治疗的经济效益。鉴于当前医疗保健面临的财政限制,证明经济效益将成为药物获批的一个越来越重要的因素。