Catalá-López Ferrán, Ridao Manuel
Departamento de Medicina, Universidad de Valencia/Instituto de Investigación Sanitaria INCLIVA y CIBERSAM, Valencia, España; Fundación Instituto de Investigación en Servicios de Salud, Valencia, España; Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canadá.
Instituto Aragonés de Ciencias de la Salud (I+CS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Zaragoza, España; FISABIO-Salud Pública, Valencia, España.
Aten Primaria. 2017 Jun-Jul;49(6):335-342. doi: 10.1016/j.aprim.2016.08.001. Epub 2017 Jan 3.
To examine the relationship between the funding source of cost-effectiveness analyses of healthcare interventions published in Spain and study conclusions.
Descriptive cross-sectional study.
Scientific literature databases (until December 2014).
PARTICIPANTS (ANALYSIS UNITS): Cohort of cost-effectiveness analysis of healthcare interventions published in Spain between 1989-2014 (n=223) presenting quality-adjusted life years (QALYs) as the outcome measure.
The relationship between qualitative conclusions of the studies and the type of funding source were established using Fisher's exact test in contingency tables. Distributions of the incremental cost-effectiveness ratios by source of funding in relation to hypothetical willingness to pay thresholds between €30,000-€50,000 per QALY were explored.
A total of 136 (61.0%) studies were funded by industry. The industry-funded studies were less likely to report unfavorable or neutral conclusions than studies non-funded by industry (2.2% vs. 23.0%; P<.0001), largely driven by studies evaluating drugs (0.9% vs. 21.4%; P<.0001). The incremental cost-effectiveness ratios in studies funded by industry were more likely to be below the hypothetical willingness to pay threshold of €30,000 (73.8% vs. 56.3%; P<.0001) and €50,000 (89.4% vs. 68.2%; P<.0001) per QALY.
This study reveals a potential sponsorship bias in cost-effectiveness analyses of healthcare interventions. Studies funded by industry could be favoring the efficiency profile of their products.
探讨西班牙发表的医疗保健干预措施成本效益分析的资金来源与研究结论之间的关系。
描述性横断面研究。
科学文献数据库（截至2014年12月）。
参与者（分析单位）：1989年至2014年在西班牙发表的医疗保健干预措施成本效益分析队列（n = 223），以质量调整生命年（QALYs）作为结局指标。
使用列联表中的Fisher精确检验确定研究的定性结论与资金来源类型之间的关系。探讨了按资金来源划分的增量成本效益比分布与每QALY 30,000欧元至50,000欧元的假设支付意愿阈值之间的关系。
共有136项研究（61.0%）由行业资助。与非行业资助的研究相比，行业资助的研究得出不利或中性结论的可能性较小（2.2%对23.0%；P <.0001），这在很大程度上是由评估药物的研究驱动的（0.9%对21.4%；P <.0001）。行业资助研究中的增量成本效益比更有可能低于每QALY 30,000欧元（73.8%对56.3%；P <.0001）和50,0
