基于前景理论的药物经济学研究

Pharmacoeconomics Research Based on Prospect Theory

目的:成本-效益分析方法是现有药物经济学评价方法中唯一能够实现健康领域与非健康领域方案间经济性评价的评价方法,但鉴于不同领域方案间所得等额效益带来的价值可能存在差异,需要进一步分析和研究。如果在价值上确实存在差异,则需对现行的成本-效益分析经济性判定标准加以修正。方法:基于前景理论价值函数构建健康领域效益价值曲线,并与非健康领域效益价值曲线对比,分析不同领域方案相同额度效益的价值差异及健康领域方案单位效益的价值变化趋势,以此为成本-效益分析经济性判定标准修正的根据。结果:健康领域效益价值曲线较非健康领域效益价值曲线上升速度更快;相同额度效益的价值,健康领域高于非健康领域;越远离完全健康状态,健康领域单位效益带来的价值越大。由此需对现行的成本-效益分析经济性判定标准加以修正。结论:涉及健康领域方案的评价选优,现行的成本-效益分析使用的ΔB/ΔC≥1,这一"金标准"过于严格,某些情况下即使ΔB/ΔC<1,从价值上的角度上考量,高成本健康领域方案也可能是经济的。

Objective:The cost-benefit analysis method is the only evaluation method for the economic evaluation of the existing health and non-health programs in the existing pharmacoeconomic evaluation methods.However,the value derived from the equal benefits between different areas may be differences,further analysis and research are needed.If difference really exist in value,the current cost-benefit analysis economic criteria should be revised.Methods:The benefit—value curve in health areas was construct based on the Prospect Theory Value Function,with a comparation of the curve in non-health areas,this study analyze the value difference of the same amount of benefits in different areas and the value change trend of unit interests in the health areas,and use this as a basis to revise the cost-benefit analysis.Results:benefit-value curve in the health areas goes up faster than in the non-health areas;value in the health areas would be higher than in the non-health one in the same amount of interest;he farther away from the full health state,the greater value unit health benefit could brought about.So it is need to amend the current cost-benefit analysis economic criteria.Conclusion:UsingΔB/ΔC≥1 as a gold standard to chose a economical program,is too strict.In some cases,even ifΔB/ΔC<1,the high-cost program in health areas may be economical from a value perspective.