Fautrel Bruno, Clarke Ann E, Guillemin Francis, Adam Viviane, St-Pierre Yvan, Panaritis Tina, Fortin Paul R, Menard Henri A, Donaldson Cam, Penrod John R
Department of Rheumatology, University of Paris VI-Pierre et Marie Curie, Hospital Pitié-Salpêtrière, Paris, France.
Med Decis Making. 2007 Mar-Apr;27(2):138-50. doi: 10.1177/0272989X06297389.
Individuals' valuation of changes in health states in monetary terms have been measured by examining changes in the direct and indirect costs of disease and by the willingness-to-pay (WTP) methodology.
In 2002, a 2-part study was conducted in Quebec. In one part of the study, 121 rheumatoid arthritis (RA) patients from the McGill University Health Centre were mailed the Stanford Cost Assessment Questionnaire, which enabled the elicitation of direct costs and indirect costs, according to the friction cost and the human capital methods. The other part was a phone survey conducted in a representative sample of the general population and in the same sample of patients, aiming to elicit the societal WTP for a complete cure of RA in the context of 2 different scenarios: a public coverage or private insurance. These estimates were then compared.
Estimates of the cost of illness of RA ranged from 11,717 to 28,498 Canadian Dollars (CAD) depending on the method. These estimates are higher than those previously published in Canada from the 1990s, which is partly due to the recent and costly biological therapies and to a change in the measurement of productivity losses. These estimates are somewhat lower than the societal WTP elicited from the WTP survey, that is, 26,717 and 36,817 CAD per RA case, depending on the public or private health insurance context in which the cure would be available.
Given that neither method is ideal, data from both methods would provide an important sensitivity analysis when monetary estimates of health state changes are required.
通过研究疾病直接和间接成本的变化以及支付意愿（WTP）方法，对个体以货币形式评估健康状态变化进行了衡量。
2002年，在魁北克进行了一项分为两部分的研究。在研究的一部分中，向麦吉尔大学健康中心的121名类风湿性关节炎（RA）患者邮寄了斯坦福成本评估问卷，该问卷能够根据摩擦成本和人力资本方法得出直接成本和间接成本。另一部分是对普通人群的代表性样本以及相同患者样本进行的电话调查，旨在得出在两种不同情况下（公共覆盖或私人保险）完全治愈RA的社会支付意愿。然后对这些估计值进行比较。
根据方法不同，RA疾病成本的估计值在11,717加元至28,498加元之间。这些估计值高于20世纪90年代加拿大此前公布的数值，部分原因是近期昂贵的生物疗法以及生产力损失衡量方法的变化。这些估计值略低于从支付意愿调查中得出的社会支付意愿，即根据治愈可获得的公共或私人医疗保险情况，每例RA病例分别为26,717加元和36,817加元。
鉴于两种方法都不理想，当需要对健康状态变化进行货币估计时，两种方法的数据都将提供重要的敏感性分析。
