成本效益分析如何为医疗决策提供信息？

How Does Cost-Effectiveness Analysis Inform Health Care Decisions?

机构信息

Assistant professor of medicine at Tufts University School of Medicine and the program director of the Cost-Effectiveness Analysis Registry at Center for the Evaluation of Value and Risk in Health at Tufts Medical Center in Boston, Massachusetts.

Professor of health economics and the Stergachis Family Endowed Director of the Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute at the University of Washington in Seattle.

出版信息

AMA J Ethics. 2021 Aug 1;23(8):E639-647. doi: 10.1001/amajethics.2021.639.

DOI:10.1001/amajethics.2021.639

PMID:34459732

Abstract

Cost-effectiveness analysis (CEA) provides a formal assessment of trade-offs involving benefits, harms, and costs inherent in alternative options. CEA has been increasingly used to inform public and private organizations' reimbursement decisions, benefit designs, and price negotiations worldwide. Despite the lack of centralized efforts to promote CEA in the United States, the demand for CEA is growing. This article briefly reviews the history of CEA in the United States, highlights advances in practice guidelines, and discusses CEA's ethical challenges. It also offers a way forward to inform health care decisions.

摘要

成本效益分析（CEA）提供了对替代方案中涉及利益、危害和成本的权衡的正式评估。CEA 在全球范围内被越来越多地用于为公共和私营组织的报销决策、福利设计和价格谈判提供信息。尽管美国没有集中精力促进 CEA，但对 CEA 的需求正在增长。本文简要回顾了 CEA 在美国的历史，重点介绍了实践指南的进展，并讨论了 CEA 的伦理挑战。它还为告知医疗保健决策提供了一种方法。