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新型听力治疗的潜在附加价值:听力损失的早期健康经济模型。

The Potential Added Value of Novel Hearing Therapeutics: An Early Health Economic Model for Hearing Loss.

机构信息

National Institute for Health Research (NIHR), University College of London Hospitals Biomedical Research Centre, evidENT, Ear Institute, University College London.

NIHR, Applied Research Collaborative (ARC) North Thames, UK.

出版信息

Otol Neurotol. 2020 Sep;41(8):1033-1041. doi: 10.1097/MAO.0000000000002744.

Abstract

OBJECTIVE

To construct an early health economic model to assess the potential added value of novel hearing therapeutics, compared with the current standard of care. We use idiopathic sudden sensorineural hearing loss (ISSNHL) as a case example, because it is a lead indication for several emerging hearing therapeutics.

METHODS

A decision analytic model was developed to assess the costs and effects of using novel hearing therapeutics for patients with ISSNHL. This was compared to the current standard of care. Input data were derived from literature searches and expert opinion. The study adopted a healthcare perspective of the UK National Health Service. Four analyses were conducted: 1) headroom, 2) scenario, 3) threshold, 4) sensitivity.

RESULTS

The decision analytic model showed that novel therapeutics for ISSNHL have potential value both in terms of improved patient outcomes, as well as incremental net monetary benefit (iNMB). The base case analysis revealed an iNMB of £39,032 for novel therapeutics compared with the current standard of care. Results of the threshold and scenario analysis revealed that age of treatment and severity of ISSNHL are major determinants of iNMB for novel therapeutics.

CONCLUSION

This article describes the first health economic model for novel therapeutics for hearing loss; and shows that novel hearing therapeutics can be cost-effective under NICE's cost-effectiveness threshold, with considerable room for improvement in the current standard of care. Our model can be used to inform the development of cost-effective hearing therapeutics; and help decision makers decide which therapeutics represent value for money.

摘要

目的

构建一个早期健康经济模型,以评估新型听力治疗方法相对于当前护理标准的潜在附加值。我们以特发性突发性聋(ISSNHL)为例,因为它是几种新兴听力治疗方法的主要适应证。

方法

开发了一个决策分析模型,以评估使用新型听力治疗方法治疗 ISSNHL 患者的成本和效果。将其与当前的护理标准进行比较。输入数据来自文献检索和专家意见。该研究采用了英国国家医疗服务体系的医疗保健视角。进行了四项分析:1)听力空间,2)情景,3)阈值,4)敏感性。

结果

决策分析模型表明,新型 ISSNHL 治疗方法在改善患者预后以及增加净货币效益(iNMB)方面具有潜在价值。基础案例分析显示,与当前的护理标准相比,新型治疗方法的 iNMB 为 39032 英镑。阈值和情景分析的结果表明,治疗的年龄和 ISSNHL 的严重程度是新型治疗方法 iNMB 的主要决定因素。

结论

本文描述了第一个用于听力损失的新型治疗方法的健康经济模型;并表明,新型听力治疗方法在 NICE 的成本效益阈值下具有成本效益,当前护理标准有很大的改进空间。我们的模型可用于为具有成本效益的听力治疗方法的开发提供信息;并帮助决策者决定哪些治疗方法具有性价比。

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