Oregon State University/Oregon Health and Science University College of Pharmacy, Collaborative Life Sciences Building (CLSB), 2730 SW Moody Ave., CL5CP, Portland, OR, 97201-5042, USA.
Neurotherapeutics. 2017 Oct;14(4):1018-1026. doi: 10.1007/s13311-017-0566-3.
Multiple sclerosis (MS) is a disabling, chronic disease that imposes a significant economic burden on patients and the US healthcare system. The largest cost component for individuals with MS are prescription drugs, specifically disease-modifying therapies (DMTs). Despite an increase in the number and diversity of DMTs over the past 10 years, acquisition costs for all DMTs have escalated dramatically at rates substantially higher than medical inflation. Currently, costs for most DMTs exceed $70,000 a year. Recent cost-effectiveness studies suggest the cost for nearly all DMTs exceeds generally accepted thresholds for what is considered a good value in the USA, even after factoring expected rebates. The high cost of DMTs is symptomatic of systemic dysfunction in the pharmaceutical market. Strategies aimed at reigning in high-cost medications include proposals ranging from increasing pricing transparency to allowing Medicare to negotiate directly with manufacturers. Because the economics of pharmaceuticals are inherently complex, a diversity of approaches will be required.
多发性硬化症（MS）是一种使人丧失能力的慢性疾病，给患者和美国医疗保健系统带来了巨大的经济负担。对于多发性硬化症患者来说，最大的成本组成部分是处方药，特别是疾病修正疗法（DMTs）。尽管在过去 10 年中，DMT 的数量和种类有所增加，但所有 DMT 的获取成本都以远高于医疗通胀的速度大幅上升。目前，大多数 DMT 的成本超过每年 70000 美元。最近的成本效益研究表明，即使考虑到预期的回扣，几乎所有 DMT 的成本都超过了在美国被认为是物有所值的普遍接受的阈值。DMT 的高成本反映了制药市场的系统性功能障碍。控制高成本药物的策略包括从提高定价透明度到允许医疗保险与制造商直接谈判的各种建议。由于药品经济学本质上很复杂，因此需要采用多种方法。
