Rajendra Arathi, Wong John B
Division of Clinical Decision Making, Department of Medicine, Tufts-New England Medical Center, Tufts University School of Medicine, 750 Washington Street, NEMC 302, Boston, MA 02111, USA.
J Hepatol. 2007 Oct;47(4):608-17. doi: 10.1016/j.jhep.2007.07.016. Epub 2007 Jul 30.
Although not all patients develop progressive liver disease, chronic hepatitis B and chronic hepatitis C infections cause substantial morbidity and mortality worldwide. To address this need, many new antiviral treatments have become available over the past 10 years. While safety, efficacy, and therapeutic indications have been well established for these agents, the economics of antiviral treatment have become increasingly a focus of discussion for physicians, policymakers, and health payers. In this paper, we will elucidate some economic principles using examples from the treatment of hepatitis B and C. In particular, we will examine the considerations in estimating drug costs, methods for performing economic analyses and lastly summarize published cost-effectiveness analyses for antiviral treatments of chronic hepatitis B and chronic hepatitis C. This review should help clinicians understand economic issues regarding new drugs and answer questions about whether the clinical benefit provided by a medication justifies its expense.
尽管并非所有患者都会发展为进行性肝病，但慢性乙型肝炎和慢性丙型肝炎感染在全球范围内导致了相当高的发病率和死亡率。为满足这一需求，在过去10年中出现了许多新的抗病毒治疗方法。虽然这些药物的安全性、有效性和治疗适应症已经得到充分确立，但抗病毒治疗的经济学已日益成为医生、政策制定者和医疗支付方讨论的焦点。在本文中，我们将通过乙型和丙型肝炎治疗的实例阐明一些经济原则。特别是，我们将研究估计药物成本时的考虑因素、进行经济分析的方法，最后总结已发表的慢性乙型肝炎和慢性丙型肝炎抗病毒治疗的成本效益分析。这篇综述应有助于临床医生理解有关新药的经济问题，并回答一种药物所提供的临床益处是否证明其费用合理的问题。
