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[神经药理学经济学]

[Neuropharmacoeconomics].

作者信息

Chiu Hou-Chang

机构信息

Department of Neurology, Shin Kong WHS Memorial Hospital, Taipei, Taiwan.

出版信息

Acta Neurol Taiwan. 2004 Jun;13(2):87-96.

Abstract

Pharmacoeconomics is concerned with how to allocate drug resources among alternative uses efficiently and effectively. Economic evaluation is a set of formal quantitative methods to capture the outcomes and costs of alternate intervention strategies. There are four basic types of economic evaluations used to assess interventions, are classified on the basis of the outcomes employed: 1. Cost minimization (CMA) is the comparison of costs of alternative interventions when the outcomes are assumed to be equal or similar, and the control intervention has been established. 2. Cost-effectiveness (CEA) is appropriate when the health outcomes are measured in common physical units, such as death or disability, or years gained or increased function, or points on cognitive scales. 3. Cost utility (CUA) is an extension of cost-effectiveness, where different types of health outcomes are weighted according to assigned values of 'quality of life' to produce a composite of both the physical measurement and the value assigned to it, e.g. quality-adjusted life years (QALY) or disability-adjusted life years (DALY). A common denominator measure of effectiveness is thus the life years of expected survival, or the QALY. The global burden disease (GBD) researchers adopted an internationally standardized form of the QALY, which they called the DALY. A quality of life measure can be translated into a scale that ranges from a low of 0.0 (the worst possible health state, usually taken as death) to 1.0 (perfect health). The purpose is to make explicit the measurement of costs and value assigned to benefits. 4. Cost-benefit (CBA) analysis value health outcomes in monetary terms, often based on the concept of 'willingness to pay'. The common drugs used by the neurologists had been discussed in this article based on the point view of pharmacoeconomics.

摘要

药物经济学关注如何在不同用途之间高效且有效地分配药物资源。经济评估是一组用于获取替代干预策略的结果和成本的正式定量方法。用于评估干预措施的经济评估有四种基本类型,根据所采用的结果进行分类:1. 成本最小化(CMA)是在假设结果相等或相似且已确定对照干预措施的情况下,对替代干预措施的成本进行比较。2. 成本效果分析(CEA)适用于以常见物理单位衡量健康结果的情况,如死亡或残疾、获得的生命年或功能改善、认知量表上的得分等。3. 成本效用分析(CUA)是成本效果分析的扩展,其中不同类型的健康结果根据“生活质量”的赋值进行加权,以产生物理测量值及其赋值的综合结果,例如质量调整生命年(QALY)或伤残调整生命年(DALY)。因此,效果的一个共同衡量标准是预期生存的生命年或QALY。全球疾病负担(GBD)研究人员采用了一种国际标准化形式的QALY,他们称之为DALY。生活质量测量可以转化为一个范围从0.0(最差的健康状态,通常视为死亡)到1.0(完美健康)的量表。目的是明确成本的测量以及赋予效益的价值。4. 成本效益分析(CBA)以货币形式评估健康结果,通常基于“支付意愿”的概念。本文从药物经济学的角度讨论了神经科医生常用的药物。

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