Centre for Health Economics, Monash Business School, Monash University, Clayton, Victoria, Australia.
Centre for Health Economics, Monash Business School, Monash University, Clayton, Victoria, Australia.
Value Health. 2018 Aug;21(8):951-957. doi: 10.1016/j.jval.2017.12.024. Epub 2018 Feb 22.
Cost-utility analysis prioritizes services using cost, life-years, and the health state utility of the life-years. Nevertheless, a significant body of evidence suggests that the public would prefer more variables to be considered in decision making and at least some sharing of the budget with services for severe conditions that are not cost-effective because of their high cost.
To examine whether this preference for sharing persists for less severe conditions when both cost effectiveness and illness severity would indicate that resources should be allocated to other services.
Survey respondents were asked to divide a budget between two patients facing life-threatening illnesses. The severity of the illnesses differed and the price of treatment was varied.
Sharing occurred in all scenarios including scenarios in which the illness was less severe and services were not cost-effective. Results are consistent with behavior commonly observed in other contexts.
Results suggest that sharing per se is important and that the public would support some funding of cost-ineffective services for less severe health problems.
成本效用分析通过成本、寿命年和寿命年的健康状态效用来优先考虑服务。然而，大量证据表明，公众希望在决策中考虑更多的变量，并至少将部分预算与治疗严重疾病的服务共享，因为这些疾病由于成本高昂而没有成本效益。
当成本效益和疾病严重程度都表明资源应分配给其他服务时，检验这种对较不严重疾病的共享偏好是否仍然存在。
调查受访者被要求在两名面临危及生命的疾病的患者之间分配预算。疾病的严重程度不同，治疗的价格也不同。
在所有情况下都存在共享，包括疾病较轻且服务无成本效益的情况。结果与在其他背景下常见的行为一致。
结果表明，共享本身很重要，公众会支持为较不严重的健康问题提供一些成本效益不佳的服务的资金。
