Bulpitt C J, Fletcher A E
Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
Am Heart J. 1990 Mar;119(3 Pt 2):766-70; discussion 770-1. doi: 10.1016/s0002-8703(05)80059-6.
Economic assessment can be incorporated into clinical trials to evaluate and compare the costs and benefits of different health care programs. In this article the three main types of evaluation are discussed: cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. The measurement of direct and indirect costs is described and specific examples are quoted. Full economic analyses are given for the use of naftidrofuryl in the treatment of acute cerebral hemisphere infarction and the use of auranofin in the treatment of rheumatoid arthritis. Economic evaluation is seen to be justified whenever a more expensive treatment is expected to produce greater benefit. Such analyses should consider quality of life and health status, as well as the more easily identifiable outcomes.
经济评估可纳入临床试验，以评估和比较不同医疗保健方案的成本和效益。本文讨论了三种主要的评估类型：成本效益分析、成本效用分析和成本效益分析。描述了直接和间接成本的计量方法，并列举了具体实例。给出了萘呋胺酯治疗急性脑半球梗死和金诺芬治疗类风湿关节炎的完整经济分析。每当预期更昂贵的治疗会产生更大效益时，经济评估就被认为是合理的。此类分析应考虑生活质量和健康状况，以及更易于确定的结果。
