Neumann Peter J, Willke Richard J, Garrison Louis P
Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA, USA.
International Society for Pharmacoeconomics and Outcomes Research, Lawrenceville, NJ, USA.
Value Health. 2018 Feb;21(2):119-123. doi: 10.1016/j.jval.2017.12.012.
Concerns about rising spending on prescription drugs and other areas of health care have led to multiple initiatives in the United States designed to measure and communicate the value of pharmaceuticals and other technologies for decision making. In this section we introduce the work of the International Society for Pharmacoeconomics and Outcomes Research Special Task Force on US Value Assessment Frameworks formed to review relevant perspectives and appropriate approaches and methods to support the definition and use of high-quality value frameworks. The Special Task Force was part of the International Society for Pharmacoeconomics and Outcomes Research Initiative on US Value Assessment Frameworks, which enlisted the expertise of leading health economists, concentrating on what the field of health economics can provide to help inform the development and use of value assessment frameworks. We focus on five value framework initiatives: the American College of Cardiology/American Heart Association, the American Society of Clinical Oncology, the Institute for Clinical and Economic Review, the Memorial Sloan Kettering Cancer Center, and the National Comprehensive Cancer Network. These entities differ in their missions, scope of activities, and methodological approaches. Because they are gaining visibility and some traction in the United States, it is essential to scrutinize whether the frameworks use approaches that are transparent as well as conceptually and methodologically sound. Our objectives were to describe the conceptual bases for value and its use in decision making, critically examine existing value frameworks, discuss the importance of sound conceptual underpinning, identify key elements of value relevant to specific decision contexts, and recommend good practice in value definition and implementation as well as areas for further research.
对处方药及医疗保健其他领域支出不断增加的担忧,促使美国开展了多项举措,旨在衡量并传达药品及其他技术在决策中的价值。在本节中,我们介绍国际药物经济学与成果研究协会美国价值评估框架特别工作组的工作,该工作组旨在审查相关观点以及支持高质量价值框架定义与使用的适当方法。特别工作组是国际药物经济学与成果研究协会美国价值评估框架倡议的一部分,该倡议征集了顶尖卫生经济学家的专业知识,重点关注卫生经济学领域能为价值评估框架的制定与使用提供哪些信息。我们聚焦于五项价值框架倡议:美国心脏病学会/美国心脏协会、美国临床肿瘤学会、临床与经济评论学会、纪念斯隆凯特琳癌症中心以及国立综合癌症网络。这些机构在使命、活动范围和方法路径上各有不同。由于它们在美国正变得越来越知名且有一定影响力,审视这些框架是否采用了透明且在概念和方法上合理的方法至关重要。我们的目标是描述价值的概念基础及其在决策中的应用,批判性地审视现有的价值框架,讨论合理概念支撑的重要性,确定与特定决策背景相关的价值关键要素,并推荐价值定义与实施方面的良好做法以及进一步研究的领域。