Willke R J, Glick H A, Polsky D, Schulman K
Pharmacia & Upjohn, Inc., Kalamazoo, MI 49001-0199, USA.
Health Econ. 1998 Sep;7(6):481-93. doi: 10.1002/(sici)1099-1050(199809)7:6<481::aid-hec353>3.0.co;2-k.
Because costs and outcomes of medical treatments may vary from country to country in important ways, decision makers are increasingly interested in having data based on their own country's health care situations. This paper proposes methods for estimating country-specific cost-effectiveness ratios from data available from multinational clinical trials. It examines how clinical and economic outcomes interact when estimating treatment effects on cost and proposes empirical methods for capturing these interactions and incorporating them when making country-specific estimates. We use data from a multinational phase III trial of tirilazad mesylate for the treatment of subarachnoid haemorrhage to illustrate these methods. Our findings suggest that it is possible for meaningful country-by-country differences to be found in such trial data. These differences can be useful in informing reimbursement, utilization, and other decisions taken at the country level.
由于医疗治疗的成本和结果在不同国家可能存在重要差异，决策者越来越希望获得基于本国医疗保健情况的数据。本文提出了从跨国临床试验可用数据中估计特定国家成本效益比的方法。它研究了在估计治疗对成本的影响时临床和经济结果如何相互作用，并提出了捕捉这些相互作用并在进行特定国家估计时将其纳入的实证方法。我们使用甲磺替拉扎特治疗蛛网膜下腔出血的跨国III期试验数据来说明这些方法。我们的研究结果表明，在此类试验数据中有可能发现有意义的国家间差异。这些差异有助于为国家层面的报销、使用及其他决策提供信息。
