Heaney D C, Sander J W, Shorvon S D
Epilepsy Research Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, WC1N 3BG, London, UK.
Epilepsy Res. 2001 Feb;43(2):89-95. doi: 10.1016/s0920-1211(00)00168-6.
To observe the degree to which prices for medical services and anti-epileptic drugs (AEDs) vary between eight European Union (EU) countries, to identify the factors that are likely to contribute to these variations and to consider the validity of international cost-of-illness comparisons. Cost-of-illness study methodology has been used to estimate the national cost of epilepsy in several developed countries. The validity of comparing these studies is unknown. Eight EU member countries were selected. Charges and prices were obtained for important aspects of medical care of patients with epilepsy including AEDs. The perspective taken was that of the major health care payer within each country. Prices were validated by a local panel of doctors expert in treating epilepsy. Prices for similar services were compared between countries. Charges and prices levied to health service payer vary widely between the eight countries considered. The cheapest and most expensive medical services vary by as much as 24 times, whereas the price of AED varies up to 4.4 times. These wide variations suggest that prices do not reflect the true cost of providing these important aspects of epilepsy treatment. International comparisons between national cost-of-illness estimates relying on such prices should be interpreted with caution.
观察八个欧盟国家之间医疗服务和抗癫痫药物（AEDs）价格的差异程度，确定可能导致这些差异的因素，并考量国际疾病成本比较的有效性。疾病成本研究方法已被用于估算几个发达国家癫痫的国家成本。比较这些研究的有效性尚不清楚。选取了八个欧盟成员国。获取了癫痫患者医疗护理重要方面（包括AEDs）的收费和价格。所采用的视角是每个国家主要的医疗保健支付方的视角。价格由当地治疗癫痫的医生专家小组进行了验证。对各国之间类似服务的价格进行了比较。在所考察的八个国家中，向医疗服务支付方收取的费用和价格差异很大。最便宜和最昂贵的医疗服务相差多达24倍，而AED的价格相差高达4.4倍。这些巨大差异表明，价格并未反映提供癫痫治疗这些重要方面的真实成本。基于此类价格的各国疾病成本估算之间的国际比较应谨慎解读。
