药物经济学中增量成本效果比(ICER)与净收益(Net Benefit)

2018-10-17 酷酷狗与天堂 酷酷狗与天堂

医药经济学评价中有一个很基础的技术问题:以何种指标来表征成本与效果的综合评估结果。 传统的,医药经济学评估采用增量成本收益比(ICER)来表征评价结果,即:成本差值/效果差值,而效果通常采用健康调整生命年(QALYs)为指标。得到ICER后,通过与界值比较来评判卫生技术的经济性。界值,在欧美发达国家通常采用5万美元,在发展中国家通常采用3倍(或者更低)人均GDP,这体现了社会为多获得一个

医药经济学评价中有一个很基础的技术问题:以何种指标来表征成本与效果的综合评估结果。 传统的,医药经济学评估采用增量成本收益比(ICER)来表征评价结果,即:成本差值/效果差值,而效果通常采用健康调整生命年(QALYs)为指标。得到ICER后,通过与界值比较来评判卫生技术的经济性。界值,在欧美发达国家通常采用5万美元,在发展中国家通常采用3倍(或者更低)人均GDP,这体现了社会为多获得一个健康生命年而愿意支付的成本。 ICER的问题在于,这是一个非线性指标,所以很难直接计算其可信区间,也不适用那些我们熟悉的假设检验和多元统计分析方法。为了分析ICER的变异度、计算可信区间,通常可以做Bootstrap抽样,从而可以得到很多自抽样的样本,计算ICER的分布和可信区间,但也仅此而已。 相对而言,净收益(Net Benefit)是一个更好的指标。这里的净收益是指:效果的差值*ICER界值-成本差值(λ*ΔE-C)。例如:成本增加了1000元,QALY增量为0.2,如果ICER界值为20000元,则净值为2000*0.2-1000=3000元。可以看到,通过界值转换,事实上将健康产出转成了货币单

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    2021-08-24 ms8000002010293138

    想看全文

    0

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    2021-03-03 355366180

    好东西,已收藏

    0

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    2019-08-04 canlab
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    2018-11-06 zexyw01
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    2019-09-14 chenwq08
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  8. [GetPortalCommentsPageByObjectIdResponse(id=1010946, encodeId=acfd101094617, content=想看全文, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4eb15569026, createdName=ms8000002010293138, createdTime=Tue Aug 24 13:39:54 CST 2021, time=2021-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=945148, encodeId=b54c945148eb, content=好东西,已收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201126/cd191656b97f470781c0bd36448d9422/aa9a30b60c6646ad94bf6f39648feb47.jpg, createdBy=58b01524016, createdName=355366180, createdTime=Wed Mar 03 15:32:06 CST 2021, time=2021-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734075, encodeId=e3ea1e340755c, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Sun Aug 04 20:58:00 CST 2019, time=2019-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2058847, encodeId=1d16205884e54, content=<a href='/topic/show?id=3481e83445e' target=_blank style='color:#2F92EE;'>#经济学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78344, encryptionId=3481e83445e, topicName=经济学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=362b271, createdName=zexyw01, createdTime=Tue Nov 06 16:58:00 CST 2018, time=2018-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1997051, encodeId=6821199e051cb, content=<a href='/topic/show?id=f97d934e3c' target=_blank style='color:#2F92EE;'>#ICER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9347, encryptionId=f97d934e3c, topicName=ICER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Sat Sep 14 22:58:00 CST 2019, time=2019-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1971652, encodeId=b99c19e16526c, content=<a href='/topic/show?id=0cdf8e8401b' target=_blank style='color:#2F92EE;'>#药物经济#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87840, encryptionId=0cdf8e8401b, topicName=药物经济)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec53439, createdName=zhty5337, createdTime=Mon Jul 29 03:58:00 CST 2019, time=2019-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331944, encodeId=750a1331944b5, content=<a href='/topic/show?id=eac1e47058' target=_blank style='color:#2F92EE;'>#FIT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7470, encryptionId=eac1e47058, topicName=FIT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Fri Oct 19 11:58:00 CST 2018, time=2018-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349710, encodeId=e4b7349e1032, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu Oct 18 07:20:34 CST 2018, time=2018-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046650, encodeId=12111046650c9, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Oct 17 23:58:00 CST 2018, time=2018-10-17, status=1, ipAttribution=)]
    2018-10-18 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2018-10-17 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0