Jolicoeur L M, Jones-Grizzle A J, Boyer J G
Glaxo Research Institute, Research Triangle Park, NC 27709.
Am J Hosp Pharm. 1992 Jul;49(7):1741-7.
The fundamentals of pharmacoeconomics are presented. Pharmacoeconomic research is used to identify, measure, and compare the costs, risks, and benefits of programs, services, or therapies and determine which alternative produces the best health outcome for the resources invested. Each pharmacoeconomic method measures costs in monetary terms; the differences lie in the valuation of outcomes. In cost-minimization analysis, the outcomes are considered to be equal and therefore are not measured. Cost-benefit analysis measures outcomes in dollars, whereas cost-effectiveness analysis measures outcomes in nonmonetary units. In cost-utility analysis, outcomes expressed in nonmonetary units are adjusted for health-related quality of life. A well-designed pharmacoeconomic analysis involves 10 steps: (1) defining the problem, (2) determining the study's perspective, (3) determining the alternatives and outcomes, (4) selecting the appropriate pharmacoeconomic method, (5) placing monetary values on the outcomes, (6) identifying study resources, (7) establishing the probabilities of the outcomes, (8) applying decision analysis, (9) discounting costs or performing a sensitivity or incremental cost analysis, and (10) presenting the results, along with any limitations of the study. By adhering to the analytic steps described, the pharmacist undertaking a pharmacoeconomic evaluation has the greatest likelihood of obtaining valid and useful results.
介绍了药物经济学的基本原理。药物经济学研究用于识别、衡量和比较项目、服务或治疗的成本、风险和效益，并确定哪种选择能为投入的资源带来最佳健康结果。每种药物经济学方法都以货币形式衡量成本；不同之处在于对结果的估值。在成本最小化分析中，结果被认为是相等的，因此无需衡量。成本效益分析以美元衡量结果，而成本效果分析以非货币单位衡量结果。在成本效用分析中，以非货币单位表示的结果会根据与健康相关的生活质量进行调整。精心设计的药物经济学分析包括10个步骤：（1）界定问题，（2）确定研究视角，（3）确定备选方案和结果，（4）选择合适的药物经济学方法，（5）对结果进行货币估值，（6）确定研究资源，（7）确定结果的概率，（8）应用决策分析，（9）对成本进行贴现或进行敏感性或增量成本分析，以及（10）呈现结果以及研究的任何局限性。通过遵循上述分析步骤，进行药物经济学评估的药剂师最有可能获得有效且有用的结果。
