Westerman I L, Bennett C L
Northwestern University, Chicago, Illinois, USA.
Stem Cells. 1996 May;14(3):312-9. doi: 10.1002/stem.140312.
In an era of health care reform, costs, cost-effectiveness and charges for health care are taking on a larger role in the decision to adopt a new therapy. Hospitals, health maintenance organizations, third-party payers, doctors and patients all have an interest in the economic factors of health care; however, not all new therapies or medications have been analyzed. Bone marrow transplantation is one of the most expensive cancer treatments, costing an average of +193,000 per patient; therefore, many economic studies have focused on the costs of the therapy. However, it is important to note that these findings are not necessarily applicable to other diseases. Cost data are not static and even small changes in protocol can make a large difference in costs. Also, cost data from outside the United States is not always applicable to the United States system due to differences such as socialized medicine, workers' wages and pharmaceutical costs. Many economic analyses focus on the hospitals' charges and extrapolate cost-effectiveness from these figures, yet the amount hospitals charge for services and products is not always relative to the costs. Therefore, third-party payer costs are also important in analyzing the cost-effectiveness of a procedure. This article will review five signature papers which illustrate important issues to consider when trying to determine the costs and cost-effectiveness of bone marrow transplants.
在医疗保健改革的时代，医疗保健的成本、成本效益和收费在采用新疗法的决策中发挥着越来越大的作用。医院、健康维护组织、第三方支付者、医生和患者都关注医疗保健的经济因素；然而，并非所有新疗法或药物都经过了分析。骨髓移植是最昂贵的癌症治疗方法之一，每位患者平均花费19.3万美元；因此，许多经济研究都集中在该疗法的成本上。然而，需要注意的是，这些研究结果不一定适用于其他疾病。成本数据并非一成不变，即使方案中的微小变化也可能导致成本产生巨大差异。此外，由于社会化医疗、工人工资和药品成本等差异，美国以外的成本数据并不总是适用于美国的医疗体系。许多经济分析关注医院的收费，并从这些数字推断成本效益，但医院对服务和产品的收费金额并不总是与成本相关。因此，第三方支付者的成本在分析一项治疗程序的成本效益时也很重要。本文将回顾五篇标志性论文，这些论文阐述了在试图确定骨髓移植的成本和成本效益时需要考虑的重要问题。
