摘要
成本-效果阈值(cost-effectiveness threshold,CET)能够判断不同医疗干预措施的经济性,是医保目录准入的一项重要参考标准,同时也是我国目前创新药物医保准入谈判所缺乏的重要药物经济学证据。文章通过分析国际上CET的应用情况进行经验总结,为我国创新药物CET的确定及应用奠定基础。CET是众多国家卫生干预措施选择的重要依据,主要分为隐性阈值和明确性阈值,大部分国家采用隐性阈值进行决策,人均GDP倍数是多国选择的CET方式。面对创新药物不同的应用场景,例如罕见病治疗、生命终末期治疗以及不同严重程度的疾病治疗等,各国在一般CET基础上进行不同程度的调整。我国的卫生决策尚未明确是否使用CET,建议在国际经验的基础上探寻符合中国国情的阈值和水平,重点探索隐性阈值在医保准入中的应用以及对罕见病和生命终末期等药物的倾斜政策,积极推进我国CET的科学确定。
Cost-effectiveness threshold(CET) can judge the economy efficiency of different medical intervention measures. It is an important reference standard for medical insurance directory access. It is also an important pharmacoeconomic evidence for the lack of medical insurance access negotiations for innovative drugs in China. This paper summarizes the experience of the application of CET in the world and lays a foundation for the determination and application of innovative drug CET in China. CET is an important basis for the selection of health interventions in many countries. It is mainly divided into implicit threshold and explicit threshold, most countries use implicit threshold for decision-making.The per capita GDP multiple is the CET mode selected by most countries. In the face of different application scenarios of innovative drugs, such as rare diseases treatment, end-stage treatment and disease treatment of different severity, countries make adjustments to different degrees on the basis of general CET. It is not clear whether CET is used in China’s health decision-making. It is suggested to explore the threshold and level in line with China’s national conditions on the basis of international experience, focus on exploring the application of hidden threshold in medical insurance access and preferential policies for rare diseases and end-of-life drugs and actively promote the scientific determination of CET in China.
作者
汤金燕
王瑞欣
闫萱萱
王一清
应晓华
TANG Jinyan;WANG Ruixin;YAN xuanxuan;WANG Yiqing;YING Xiaohua(School of Public Health,Fudan University,Shanghai 200032,China)
出处
《世界临床药物》
CAS
2022年第10期1269-1276,共8页
World Clinical Drug
关键词
创新药物
医保准入
成本-效果阈值
测算方法
药物经济学
innovative drugs
medical insurance access
cost-effectiveness threshold
calculation method
pharmacoeconomics
