Suwantika Auliya A, Kautsar Angga P, Zakiyah Neily, Abdulah Rizky, Boersma Cornelis, Postma Maarten J
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.
Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia.
Ther Clin Risk Manag. 2020 Oct 14;16:969-977. doi: 10.2147/TCRM.S260377. eCollection 2020.
The annual gross domestic expenditure on research and development (GERD) per capita of Indonesia ($24) remains relatively lower than the annual GERD per capita of neighboring countries, such as Vietnam ($36), Singapore ($1804), Malaysia ($361), and Thailand ($111).
The aim of this study was to conduct a cost-effectiveness analysis of spending on healthcare R&D to address the needs of developing innovative therapeutic products in Indonesia.
A decision tree model was developed by taking into account four stages of R&D: stage 1 from raw concept to feasibility, stage 2 from feasibility to development, stage 3 from development to early commercialization, and stage 4 from early to full commercialization. Considering a 3-year time horizon, a stage-dependent success rate was applied and analyses were conducted from a business perspective. Two scenarios were compared by assuming the government of Indonesia would increase GERD in health and medical sciences up to 2- and 3-times higher than the baseline (current situation) for the first and second scenario, respectively. Cost per number of innovative products in health and medical sciences was considered as the incremental cost-effectiveness ratio (ICER). Univariate sensitivity analysis was conducted to investigate the effects of different input parameters on the ICER.
There was a statistically significant association (-value<0.05) between countries' GERD in medical and health sciences with the number of innovative products. We estimated the ICER would be $8.50 million and $2.04 million per innovative product for the first and second scenario, respectively. The sensitivity analysis showed that the success rates in all stages and total GERD were the most influential parameters impacting the ICER.
The result showed that there was an association between GERD in medical and health sciences with the number of innovative products. In addition, the second scenario would be more cost-effective than the first scenario.
印度尼西亚的人均年度国内研发支出（GERD）为24美元，仍相对低于越南（36美元）、新加坡（1804美元）、马来西亚（361美元）和泰国（111美元）等邻国的人均年度GERD。
本研究旨在对医疗保健研发支出进行成本效益分析，以满足印度尼西亚开发创新治疗产品的需求。
通过考虑研发的四个阶段开发了一个决策树模型：第1阶段从原始概念到可行性，第2阶段从可行性到开发，第3阶段从开发到早期商业化，并第4阶段从早期到全面商业化。考虑到3年的时间跨度，应用了与阶段相关的成功率，并从商业角度进行了分析。通过假设印度尼西亚政府将健康和医学科学领域的GERD分别提高到比基线（当前情况）高2倍和3倍，比较了两种情景。健康和医学科学领域创新产品数量的成本被视为增量成本效益比（ICER）。进行单变量敏感性分析以研究不同输入参数对ICER的影响。
各国医疗和健康科学领域的GERD与创新产品数量之间存在统计学上的显著关联（P值<0.05）。我们估计，第一种情景和第二种情景下每个创新产品的ICER分别为850万美元和204万美元。敏感性分析表明，所有阶段的成功率和总GERD是影响ICER的最有影响力的参数。
结果表明，医疗和健康科学领域的GERD与创新产品数量之间存在关联。此外，第二种情景比第一种情景更具成本效益。
