Salamzadeh Jamshid, Foroutan Naghmeh, Jamshidi Hamid Reza, Rasekh Hamid Reza, Rajabzadeh Gatari Ali, Foroutan Arash, Nafar Mohsen
Department of Pharmacoeconomics and Pharmaceutical Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tarbiat Modares University.
Iran J Pharm Res. 2014 Winter;13(1):271-8.
The primary aim of the study was to estimate costs of treatment for the first year after renal transplantation from the perspective of health insurance organizations in Iran. An Excel-based and a Monte Carlo model were developed to determine the treatment costs of current clinical practice in renal transplantation therapy (RTT). Inputs were derived from Ministry of Health and insurance organizations database, hospital and pharmacy records, clinical trials and local and international literature. According to the model, there were almost 17,000 patients receiving RTT in Iran, out of which about 2,200 patients underwent the operation within the study year (2011 - 2012; n = 2,200) The estimated first year total treatment cost after renal transplantation was almost $14,000,000. These costs corresponded to annual total cost per patient of almost $6500 for the payers. Renal transplantation therapy is almost fully reimbursed by government in Iran. However, regarding new expensive medicines, cost of medical expenditure is rapidly growing and becoming quite unaffordable for the government; therefore, out-of-pocket (OOP) payments are dramatically increasing over time. In order to improve reimbursement policy making under pressure of current budget constraints, the present study is providing decision makers with practical tools make it possible for them to easily compare budgetary impact of the current therapy strategy with the future financial consequences of purchasing newly proposed medicines. In other words having estimation of the current budget spending on RTT would help policy makers in making efficient resource allocation and decrease quite high OOP expenditures.
该研究的主要目的是从伊朗医疗保险组织的角度估算肾移植后第一年的治疗费用。开发了一个基于Excel的模型和一个蒙特卡洛模型，以确定肾移植治疗（RTT）当前临床实践的治疗费用。输入数据来自伊朗卫生部和保险组织的数据库、医院和药房记录、临床试验以及国内外文献。根据该模型，伊朗有近17000名患者接受肾移植治疗，其中约2200名患者在研究年度（2011 - 2012年；n = 2200）内接受了手术。肾移植后第一年的估计总治疗费用约为1400万美元。这些费用相当于支付方每位患者每年近6500美元的总成本。在伊朗，肾移植治疗几乎完全由政府报销。然而，对于新的昂贵药物，医疗支出成本正在迅速增长，政府已难以承受；因此，自付费用随着时间的推移大幅增加。为了在当前预算限制的压力下改进报销政策制定，本研究为决策者提供了实用工具，使他们能够轻松比较当前治疗策略的预算影响与购买新提议药物的未来财务后果。换句话说，估算当前肾移植治疗的预算支出将有助于政策制定者进行有效的资源分配，并减少相当高的自付费用支出。
