Gan T, Sloan F, Dear G de L, El-Moalem H E, Lubarsky D A
Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.
Anesth Analg. 2001 Feb;92(2):393-400. doi: 10.1097/00000539-200102000-00022.
Postoperative nausea and vomiting (PONV) are unpleasant experiences. However, there is no drug that is completely effective in preventing PONV. Whereas cost effectiveness analyses rely on specific health outcomes (e.g., years of life saved), cost-benefit analyses assess the cost and benefit of medical therapy in terms of dollars. We hypothesized that patients were willing to pay for a hypothetical new drug that would eliminate PONV. Eighty elective day surgical patients using general anesthesia participated in the study. After their recovery in the postanesthetic care unit, they were asked to complete an interactive computer questionnaire on demographics, the value of avoiding PONV, and their willingness to pay for an antiemetic. Patients were willing to pay US$56 (US$26--US$97; median, 25%--75%) for an antiemetic that would completely prevent PONV. Patients who developed nausea (n = 21; 26%) and vomiting (n = 9; 11%) were willing to pay US$73 (US$44--US$110) and $100 (US$61--US$200; median, 25%--75%), respectively (P < 0.05). Seventy-six percent of patients considered avoiding postoperative nausea and 78% of patients considered avoiding vomiting as important (> or = 50 mm on a 0--100-mm visual analog scale). Nausea or vomiting in the postanesthetic care unit, greater patient income, previous history of PONV, more importance placed on avoiding nausea and vomiting, increasing age, and being married are independent covariates that increase the willingness to pay estimates. Patients associated a value with the avoidance of PONV and were willing to pay between US$56 and US$100 for a completely effective antiemetic.
术后恶心呕吐（PONV）是令人不适的经历。然而，尚无药物能完全有效预防PONV。成本效益分析依赖于特定的健康结果（如挽救的生命年数），而成本效益分析则以美元为单位评估药物治疗的成本和效益。我们假设患者愿意为一种能消除PONV的假想新药付费。80例接受全身麻醉的择期日间手术患者参与了该研究。在麻醉后护理单元恢复后，他们被要求完成一份关于人口统计学、避免PONV的价值以及他们为一种止吐药付费意愿的交互式计算机问卷。患者愿意为一种能完全预防PONV的止吐药支付56美元（26美元 - 97美元；中位数，25% - 75%）。出现恶心（n = 21；26%）和呕吐（n = 9；11%）的患者分别愿意支付73美元（44美元 - 110美元）和100美元（61美元 - 200美元；中位数，25% - 75%）（P < 0.05）。76%的患者认为避免术后恶心很重要，78%的患者认为避免呕吐很重要（在0 - 100毫米视觉模拟量表上≥50毫米）。麻醉后护理单元出现恶心或呕吐、患者收入较高、既往PONV病史、更重视避免恶心和呕吐、年龄增加以及已婚是增加支付意愿估计值的独立协变量。患者将避免PONV与一定价值联系起来，并且愿意为一种完全有效的止吐药支付56美元至100美元。
