Inotai András, Kaló Zoltán, Mészáros Agnes
Semmelweis Egyetem, Egyetemi Gyógyszertár Gyógyszerügyi Szervezési Intézet, Budapest.
Acta Pharm Hung. 2009;79(2):63-9.
Cost-effectiveness evidence has become mandatory criteria before reimbursement of pharmaceuticals in several countries due to scarcity of resources for health care. Data for cost-effectiveness analysis can rarely be gained from a single clinical trial. As a method to synthesize input data from different sources, economic modelling earns increasing importance in the assessment of health technologies. This review paper depicts the main features of standard economic modelling techniques with special focus on decision tree and Markov models. It summarizes the interpretation of incremental cost-effectiveness ratio and sensitivity analysis for decision-making purposes. There is a trade-off between the transparency and complexity of economic models. It is important to develop economic models according to the best available scientific evidence and modelling standards, however the search for absolute accuracy in economic modelling of health care technologies may not improve the appropriateness of reimbursement decisions.
由于医疗保健资源稀缺,成本效益证据已成为一些国家药品报销前的强制标准。成本效益分析的数据很少能从单一临床试验中获得。作为一种综合不同来源输入数据的方法,经济建模在卫生技术评估中变得越来越重要。这篇综述文章描述了标准经济建模技术的主要特点,特别关注决策树和马尔可夫模型。它总结了增量成本效益比的解释和用于决策目的的敏感性分析。经济模型的透明度和复杂性之间存在权衡。根据现有的最佳科学证据和建模标准开发经济模型很重要,然而在医疗保健技术的经济建模中追求绝对准确性可能不会提高报销决策的适当性。