四大洲十个国家成本效益阈值的系统综述。
Systematic overview of cost-effectiveness thresholds in ten countries across four continents.
作者信息
Schwarzer Ruth, Rochau Ursula, Saverno Kim, Jahn Beate, Bornschein Bernhard, Muehlberger Nikolai, Flatscher-Thoeni Magdalena, Schnell-Inderst Petra, Sroczynski Gaby, Lackner Martina, Schall Imke, Hebborn Ansgar, Pugner Karl, Fehervary Andras, Brixner Diana, Siebert Uwe
机构信息
Department of Public Health, Health Services Research & Health Technology Assessment, Institute of Public Health, Medical Decision Making & Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics & Technology, Eduard Wallnoefer Center I, 6060 Hall i.T., Austria.
Division of Public Health Decision Modelling, Health Technology Assessment & Health Economics, ONCOTYROL - Center for Personalized Cancer Medicine, Innrain 66a, 6020 Innsbruck, Austria.
出版信息
J Comp Eff Res. 2015 Sep;4(5):485-504. doi: 10.2217/cer.15.38.
AIM
To provide an overview of thresholds for incremental cost-effectiveness ratios (ICERs) representing willingness-to-pay (WTP) across multiple countries and insights into exemptions pertaining to the ICER (e.g., cancer). To compare ICER thresholds to individual country's estimated ability-to-pay.
MATERIALS & METHODS: We included AHRQ/USA, BIQG-GOEG/Austria, CADTH/Canada, DAHTA@DIMDI/Germany, DECIT-CGATS/Brazil, HAS/France, HITAP/Thailand, IQWiG/Germany, LBI-HTA/Austria, MSAC/Australia, NICE/England/Wales and SBU/Sweden. ICER thresholds were derived from systematic literature/website search/expert surveys. WTP was compared with ATP using Spearman's rank correlation.
RESULTS
Two general and explicitly acknowledged thresholds (England/Wales, Thailand), implicit thresholds in six countries and different ICER thresholds/decision-making rules in oncology were identified. Correlation between WTP and ability-to-pay was moderate.
DISCUSSION
Our overview supports country-specific discussions on WTP and on how to define value(s) within societies.
目的
概述代表多个国家支付意愿（WTP）的增量成本效益比（ICER）阈值，并深入了解与ICER相关的豁免情况（如癌症）。比较ICER阈值与各个国家估计的支付能力。
材料与方法
我们纳入了美国医疗保健研究与质量局（AHRQ）、奥地利生物医学质量与效率研究所（BIQG-GOEG）、加拿大药物和卫生技术局（CADTH）、德国医疗卫生数据中心（DAHTA@DIMDI）、巴西卫生技术评估与创新决策中心（DECIT-CGATS）、法国卫生高级管理局（HAS）、泰国卫生系统研究所在健康促进方面的工作（HITAP）、德国卫生经济与质量研究所（IQWiG）、奥地利卫生技术评估研究所（LBI-HTA）、澳大利亚医疗服务咨询委员会（MSAC）、英国国家卫生与临床优化研究所（NICE）（英格兰/威尔士）以及瑞典卫生技术评估委员会（SBU）。ICER阈值来自系统的文献检索/网站搜索/专家调查。使用斯皮尔曼等级相关性将WTP与支付能力进行比较。
结果
确定了两个普遍且明确认可的阈值（英格兰/威尔士、泰国）、六个国家的隐含阈值以及肿瘤学中不同的ICER阈值/决策规则。WTP与支付能力之间的相关性为中等。
讨论
我们的概述支持针对特定国家关于WTP以及如何在社会中定义价值的讨论。
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