Claxton Karl P, Sculpher Mark J
Centre for Health Economics, University of York, York, England.
Pharmacoeconomics. 2006;24(11):1055-68. doi: 10.2165/00019053-200624110-00003.
Decisions to adopt, reimburse or issue guidance on the use of health technologies are increasingly being informed by explicit cost-effectiveness analyses of the alternative interventions. Healthcare systems also invest heavily in research and development to support these decisions. However, the increasing transparency of adoption and reimbursement decisions, based on formal analysis, contrasts sharply with research prioritisation and commissioning. This is despite the fact that formal measures of the value of evidence generated by research are readily available. The results of two recent opportunities to apply value of information analysis to directly inform policy decisions about research priorities in the UK are presented. These include a pilot study for the UK National Co-ordinating Centre for Health Technology Assessment (NCCHTA) and a pilot study for the National Institute for Health and Clinical Excellence (NICE). We demonstrate how these results can be used to address a series of policy questions, including: is further research required to support the use of a technology and, if so, what type of research would be most valuable? We also show how the results can be used to address other questions such as, which patient subgroups should be included in subsequent research, which comparators and endpoints should be included, and what length of follow up would be most valuable.
关于采用、报销或发布健康技术使用指南的决策，越来越多地依据对替代干预措施的明确成本效益分析来做出。医疗保健系统也在研发方面投入大量资金以支持这些决策。然而，基于正式分析的采用和报销决策透明度不断提高，这与研究优先级确定和委托形成了鲜明对比。尽管有现成的研究产生证据价值的正式衡量标准，但情况依然如此。本文介绍了最近两次将信息价值分析应用于直接为英国研究优先级政策决策提供信息的机会的结果。这些包括为英国国家卫生技术评估协调中心（NCCHTA）开展的一项试点研究以及为国家卫生与临床优化研究所（NICE）开展的一项试点研究。我们展示了这些结果如何用于解决一系列政策问题，包括：是否需要进一步研究以支持某项技术的使用，如果需要，哪种类型的研究最有价值？我们还展示了这些结果如何用于解决其他问题，例如，后续研究应纳入哪些患者亚组，应纳入哪些对照和终点，以及多长的随访时间最有价值。
