Department of Public Health, Faculty of Medicine, Heinrich-Heine University, Düsseldorf, Germany.
Expert Rev Pharmacoecon Outcomes Res. 2011 Aug;11(4):403-9. doi: 10.1586/erp.11.45.
The Institute for Quality and Efficiency in Health Care in Germany makes recommendations for ceiling prices of drugs based on an evaluation of the relationship between costs and effects in each therapeutic area. The analysis requires, when applicable, calculation of savings from avoided clinical events and increased future health expenditures from prolonging life (i.e., downstream costs). This article suggests that because of the specific requirements of the Institute for Quality and Efficiency in Health Care, in some cases calculation of downstream costs is not necessary when clinical outcomes are used as a measure of effectiveness. In this article, we identify these conditions. If they hold, it will reduce data requirements, the costs and time required to conduct evaluations, and the uncertainty in the analysis.
德国卫生保健质量和效率研究所（Institute for Quality and Efficiency in Health Care in Germany）根据对每个治疗领域的成本与效果关系的评估，为药品设定最高限价。分析需要时，还需要计算避免临床事件所节省的费用以及因延长寿命而增加的未来健康支出（即下游成本）。本文提出，由于德国卫生保健质量和效率研究所的特殊要求，在将临床结果作为疗效衡量标准的情况下，并非在所有情况下都需要计算下游成本。本文确定了这些条件。如果这些条件成立，将减少数据分析要求、评估所需的成本和时间，以及分析的不确定性。
