Department of Neurology, University of Virginia, Charlottesville, VA, USA.
Beth Israel Deaconess Medical Center, Jerome H. Grossman M.D. Graduate Fellow, Harvard Kennedy School, Boston, MA, USA.
Muscle Nerve. 2020 Nov;62(5):573-578. doi: 10.1002/mus.27018. Epub 2020 Jul 29.
Escalating drug costs place patients at risk for financial toxicity and demand that physicians understand and act on the ethical and economic principles related to drug pricing. This manuscript reviews these principles and provides clinicians with a framework to think about the value of the drugs prescribed for patients with neuromuscular diseases. A key component of addressing the drug pricing crisis will be establishing a value based (benefit/cost) drug pricing framework. Determining the value of a drug is difficult and requires estimating the benefit and costs to patients and society while integrating indirect and contextual variables. Other considerations in drug pricing include "externality," the value to society derived from innovation. The Institute for Clinical and Economic Review (ICER) is a leading independent research organization providing clinicians with value-based price "benchmarks." All physicians must educate themselves in drug pricing principles and be prepared to have conversations regarding individual and societal value with the patients they serve.
不断上涨的药价使患者面临财务毒性的风险，这要求医生了解并遵守与药品定价相关的伦理和经济原则。本文回顾了这些原则，并为临床医生提供了一个思考治疗神经肌肉疾病患者所开药物价值的框架。解决药品定价危机的一个关键部分将是建立基于价值（效益/成本）的药品定价框架。确定药物的价值是困难的，需要估计对患者和社会的效益和成本，同时整合间接和背景变量。药品定价的其他考虑因素包括“外部性”，即创新为社会带来的价值。临床和经济审查学会（ICER）是一家领先的独立研究机构，为临床医生提供基于价值的价格“基准”。所有医生都必须学习药品定价原则，并准备好与他们所服务的患者就个人和社会价值进行对话。
