2009～2010药物经济学学科发展

本文从药物经济学的理论研究进展、应用研究进展、学科发展动态等几方面综述了近两年来药物经济学的学科发展状况。在成本研究方面,多重估算法提高了多中心成本测量的准确性。在健康产出研究方面,推荐使用低于各国指南中的折现率对健康产出进行折现,健康产出的其它研究集中于阐明了选择短期健康状态偏好评估方法的原则;进一步探索了不同应答人群对同一健康状态赋值差异的大小和原因;极值健康状态的定义和测量偏差对QALY值的影响;多维健康状态量表在各国的验证和使用等。在不确定性分析方面,研究集中于更好地应用概率敏感度分析。在应用方面,ISPOR对药品成本的测量和生产力损失赋值提供了更新的指南和推荐,荷兰的研究表明QALY阈值的正式使用降低其国家药品费用。亚洲的一些政策制定者也开始参考药物经济学证据来指导决策。我国在人才培养、教材出版和学术组织平台建设等方面均有所发展。

This paper has reviewed subject evolvements in the latest two years for pharmacoeconomics in terms of theoretical study advancement,applied research progress,disciplinary development trends and other aspects.Concerning cost study multi-level estimation can increase accuracy of multi-centre cost measurement.From the perspective of health outcome research,it is highly recommended that health consequences be discounted by a discount rate lowering than that set by guidelines;other study regarding to health outcomes focus on illustrating the principles to estimate short-period health status preferences;further more it explores the magnitude on varied values derived from different respondents to the same health status as well as its causes;the definition of extreme health status and the impact on QALY from measurement bias;the application and validation of EQ-5D in different nations.Studies about uncertainty analyses tend to focus on using probabilistic sensitivity analysis.In application of pharmacoeconomics,ISPOR has proposed updated guidelines and recommendations on measurement of drug cost and productivity loss.A study undertaken in Netherland proved that implementation of QALY threshold decreased its drug expenditure.Policy makers in Asian countries have gradually referred to economic evidences to guide decision-making.Our county has maintained developments in talents training,textbook publishing as well as academic platform construction.