Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Rm 689, Baltimore, MD 21205, USA.
Expert Rev Pharmacoecon Outcomes Res. 2008 Feb;8(1):73-9. doi: 10.1586/14737167.8.1.73.
Breakthroughs in genetic testing have informed patients and physicians in the treatment of breast cancer; however, they have also added to the complexity of decision-making. Genetic testing for breast cancer susceptibility not only changes treatment and screening options, but also challenges the way in which interventions are evaluated. While comparative effectiveness and cost-effective analysis methods are now standard for evaluation at the societal level, technologies such as genetic testing require us to consider the role of patient preference, especially as we move towards more personalized approaches to medicine. In this review, we discuss the changing role of pharmacoeconomics and outcomes research by highlighting how the discipline could use patient preference methods, such as conjoint analysis, to promote shared decision-making and to empower breast cancer patients. By adopting these methods we could move our focus from what is best for payers or society to one that applies scientific methods to identify what is best for patients.
基因检测的突破为乳腺癌的治疗提供了患者和医生所需的信息；然而，这也增加了决策的复杂性。乳腺癌易感性的基因检测不仅改变了治疗和筛查方案，还对干预措施的评估方式提出了挑战。虽然比较有效性和成本效益分析方法现已成为评估社会层面的标准，但基因检测等技术要求我们考虑患者偏好的作用，尤其是当我们朝着更个性化的医学方法发展时。在这篇综述中，我们通过强调该学科如何使用患者偏好方法（如联合分析）来促进共同决策并赋予乳腺癌患者权力，讨论了药物经济学和结果研究的不断变化的角色。通过采用这些方法，我们可以将注意力从最适合支付者或社会的方法转移到应用科学方法来确定最适合患者的方法上。
