Refoios Camejo Rodrigo, Miraldo Marisa, Rutten Frans
Institute of Health Policy & Management, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands; GlaxoSmithKline, Value Evidence & Outcomes, London, UK.
Imperial College Business School, Healthcare Management Group, London, UK.
Value Health. 2017 Feb;20(2):240-243. doi: 10.1016/j.jval.2016.12.004.
The majority of the current systems spread across the world require the value of pharmaceuticals to be demonstrated with an acceptable degree of certainty before a technology is funded. Often involving the notion of cost-effectiveness, one of the key characteristics of such assessments tends to be the consideration of efficiency as a static outcome; with a strong emphasis on current health gains but a disregard for the impact of decision making on the potential health value over time. In this article, we argue that current systems using cost-effectiveness thresholds may provide an incomplete indicator of value. We defend the idea that funding decisions should also be informed by dynamic efficiency considerations and reflect both the current and the future value of achieving a certain level of effectiveness in a specific disease area. We further lay down the foundations for the implementation of such a value assessment framework.
当前全球范围内的大多数系统都要求在为一项技术提供资金之前，要以可接受的确定程度证明药品的价值。这类评估通常涉及成本效益概念，其关键特征之一往往是将效率视为静态结果来考量；高度重视当前的健康收益，却忽视决策对长期潜在健康价值的影响。在本文中，我们认为当前使用成本效益阈值的系统可能提供了一个不完整的价值指标。我们支持这样一种观点，即资金决策也应考虑动态效率因素，并反映在特定疾病领域实现一定疗效水平的当前和未来价值。我们还为实施这样一个价值评估框架奠定了基础。
