Basu Anirban, Axelsen Kirsten, Grabowski David C, Meltzer David O, Polsky Daniel, Ridley David B, Wiederkehr Daniel, Philipson Tomas J
*Pharmaceutical Outcome Research and Policy Program, Department of Pharmacy, University of Washington, Seattle, WA †Pfizer Inc., New York, NY ‡Department of Health Care Policy at Harvard Medical School, Boston, MA §Departments of Medicine and Economics, and the School of Public Policy Studies, University of Chicago, IL ∥Departments of Medicine and Health Care Management at Wharton School, University of Pennsylvania, PA ¶The Fuqua School of Business, Duke University, Durham, NC #Harris School of Public Policy Studies, University of Chicago, Chicago, IL.
Med Care. 2016 Dec;54(12):1038-1044. doi: 10.1097/MLR.0000000000000603.
As real-world data (RWD) in health care begin to cross over to the Big Data realms, a panel of health economists was gathered to establish how well the current US policy environment further the goals of RWD and, if not, what can be done to improve matters. This report summarizes these discussions spanning the current US landscape of RWD availability and usefulness, private versus public development of RWD assets, the current inherent bias in terms of access to RWD, and guiding principles in providing quality assessments of new RWD studies. Three main conclusions emerge: (1) a business case is often required to incentivize investments in RWD assets. However, access restrictions for public data assets have failed to generate a proper market for these data and hence may have led to an underinvestment of public RWDs; (2) Very weak empirical evidence exist on for-profit entities misusing public RWD data entities to further their own agendas, which is the basis for supporting access restrictions of public RWD data; and (3) perhaps developing standardized metrics that could flag misuse of RWDs in an efficient way could help quell some of the fear of sharing public RWD assets with for-profit entities. It is hoped that these discussions and conclusions would pave the way for more rigorous and timely debates on the greater availability and accessibility of RWD assets.
随着医疗保健领域的真实世界数据(RWD)开始进入大数据领域,一个健康经济学家小组聚集在一起,以确定当前美国政策环境在多大程度上推动了RWD的目标,如果没有,该如何改进。本报告总结了这些讨论,内容涵盖美国当前RWD的可用性和实用性、RWD资产的私人与公共开发、当前获取RWD方面固有的偏差,以及对新RWD研究进行质量评估的指导原则。得出了三个主要结论:(1)通常需要一个商业案例来激励对RWD资产的投资。然而,对公共数据资产的访问限制未能为这些数据创造一个合适的市场,因此可能导致对公共RWD的投资不足;(2)几乎没有确凿的实证证据表明营利性实体滥用公共RWD数据实体来推进自身议程,而这正是支持对公共RWD数据进行访问限制的依据;(3)或许开发能够有效标记RWD滥用情况的标准化指标,有助于平息一些与营利性实体共享公共RWD资产的担忧。希望这些讨论和结论能够为就RWD资产的更多可用性和可及性进行更严格、及时的辩论铺平道路。