以1~3倍人均GDP作为药物经济学阈值的文献溯源及概念分析

Literature Tracing and Conceptual Analysis of 1-3 times GDP per Capita as Pharmacoeconomic Threshold

目的:详述以1~3倍人均GDP作为药物经济学评价阈值的历史渊源及应用现状。方法:基于文献溯源和概念分析的方法对已有文献进行梳理总结。结果:1~3倍人均GDP阈值最初是以可避免的伤残调整生命年作为结果指标的平均成本效果比的阈值,后来学者逐渐以质量调整生命年替代伤残调整生命年作为结果指标,同时挪用其为增量成本效果比的阈值。结论:以1~3倍人均GDP作为药物经济学评价阈值无可负担性保证;该阈值假设条件不合理;同时,使用1~3倍GDP作为阈值时评价结果不具有外推性。

Objective:It elaborates the historical pass and the empirical status of 1~3 GDP thresholds.Methods:Literature tracing and conceptual analysis are to summarize the literature.Results:The threshold is set for average cost per effectiveness,where averted Disability Adjusted Life Year(DALY)is applied as effectiveness measure. Gradually,researchers adopt Quality Adjusted Life Year(QALY) instead of DALY as health-related outcome;meanwhile 1~3 GDP thresholds is taken as threshold of incremental cost-effectiveness ratio.Conclusion:There is no budget limit while applying 1~3 GDP thresholds;the underlying assumption is the not reasonable;meanwhile,there is no extrapolation for the evaluation result while applying 1~3 GDP thresholds.