Department of Economics, Fordham University, Bronx, NY, USA.
Health Econ. 2012 Aug;21(8):967-76. doi: 10.1002/hec.1774. Epub 2011 Jul 18.
A three-equation model is used to estimate the multiple effects of antiretroviral medications (ARVs) on the quality of life (QoL) of the elderly with HIV in New York City. The transmission mechanism involves the ARVs having a direct effect on QoL via the side effects of the medications and two other effects (one indirect and one reverse) both working through feelings of depression. On a scale of 0 to 100, ARVs raise the QoL by 1 percentage point. This was because there was a large positive indirect effect of ARVs on QoL of 28 percentage points via the reduction in depression, which offsets both the 24 percentage-point reduction due to the direct effect and the 3 percentage-point decline from the reverse effect. Now, QoL effects can be applied to the additional life years generated by ARVs to form the quality adjusted life years outcome measure for use in economic evaluations of ARVs.
采用三方程模型估计抗逆转录病毒药物（ARV）对纽约市老年 HIV 患者生活质量（QoL）的多重影响。传播机制涉及 ARV 通过药物的副作用对 QoL 产生直接影响，以及通过抑郁感产生的另外两个影响（一个间接影响和一个反向影响）。在 0 到 100 的范围内，ARV 将 QoL 提高了 1 个百分点。这是因为 ARV 通过降低抑郁感对 QoL 产生了 28 个百分点的巨大积极间接影响，抵消了直接影响导致的 24 个百分点的降低和反向影响导致的 3 个百分点的下降。现在，QoL 效应可以应用于 ARV 产生的额外生命年来形成质量调整生命年结果测量，用于 ARV 的经济评估。
