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基于价值的系统性治疗:未来之路。

Value-Based Care in Systemic Therapy: The Way Forward.

机构信息

Department of Oncology, MOSC Medical College, Ernakulam 682311, Kerala, India.

Government Medical College, Thrissur 680596, Kerala, India.

出版信息

Curr Oncol. 2022 Aug 16;29(8):5792-5799. doi: 10.3390/curroncol29080456.

Abstract

The rising cost of cancer care has shed light on an important aspect of healthcare delivery. Financial toxicity of therapy must be considered in clinical practice and policy-making. One way to mitigate the impact of financial toxicity of cancer care is by focusing on an approach of healthcare delivery that aims to deliver value to the patient. Should value of therapy be one of the most important determinants of cancer care? If so, how do we measure it? How can we implement it in routine clinical practice? In this viewpoint, we discuss value-based care in systemic therapy in oncology. Strategies to improve the quality of care by incorporating value-based approaches are discussed: use of composite tools to assess the value of drugs, alternative dosing strategies, and the use of Health Technology Assessment in regulatory procedures. We propose that there must be a greater emphasis on value of therapy in determining its use and its cost.

摘要

癌症治疗费用的不断上涨凸显了医疗服务提供的一个重要方面。在临床实践和决策中必须考虑治疗的经济毒性。减轻癌症治疗经济毒性影响的一种方法是关注旨在为患者提供价值的医疗服务提供方法。治疗的价值应该成为癌症护理最重要的决定因素之一吗?如果是这样,我们如何衡量它?我们如何将其实施到常规临床实践中?在本观点中,我们讨论了肿瘤学中系统治疗的基于价值的护理。讨论了通过采用基于价值的方法来提高护理质量的策略:使用综合工具来评估药物的价值、替代剂量策略以及在监管程序中使用卫生技术评估。我们提出,在确定治疗的使用及其成本时,必须更加重视治疗的价值。

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Cancer J. 2020 Jul/Aug;26(4):311-322. doi: 10.1097/PPO.0000000000000459.
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Cancer Epidemiol Biomarkers Prev. 2020 Jul;29(7):1304-1312. doi: 10.1158/1055-9965.EPI-19-1534. Epub 2020 Jun 10.
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Support Care Cancer. 2020 Oct;28(10):4561-4573. doi: 10.1007/s00520-020-05512-y. Epub 2020 May 21.

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