国外普适性药物价值评价工具对构建中成药药物价值评价工具的思考

Thoughts on foreign universal drug value evaluation tools for construction of Chinese patent medicine value evaluation tools

目前,我国中成药的价值评价正处于探索阶段,尚未建立起能够反映中医药特点的临床价值评价体系。该文考察了4种国外普适性药物价值评价工具,分别是证据评级矩阵、癌症价值标签、患者视角价值框架和多准则决策分析高级价值框架。证据评级矩阵用于衡量不同治疗措施获益与风险,以净健康获益作为最佳估计点评价药物的治疗价值;癌症价值标签主要是通过计算预期临床结果与预成本之间的比率,通过矩阵形式来权衡不同抗肿瘤药物治疗方案的经济价值和创新价值;患者视角价值框架则强调从患者的视角来评价不同医疗保健措施的价值;多准则决策分析高级价值框架从多维度衡量药物或措施的价值。结合以上普适性药物价值评价工具的特点和国内药物价值评估的相关研究,该文提出从中成药药物的有效性、安全性、创新性、经济性、适宜性和可及性6个维度的指标体系分析中成药药物价值评价的特征,并阐述了构建中成药价值评价工具的策略,以期为中成药的价值评价和决策应用提供依据。

At present, the value evaluation of Chinese patent medicines is in the exploratory stage, and a clinical value evaluation system that can reflect the characteristics of traditional Chinese medicine has not been established. This article investigates four universal drug value tools from abroad, namely, evidence rating matrix, cancer value label, patient-perspective value framework and multiple criteria decision analysis advance value framework. The evidence rating matrix is used to measure the benefits and risks of different treatment measures, and the net health benefit is used as the best estimate point to evaluate the value of treatment;the cancer value label is mainly used to weigh the economic value and innovative value of drug treatment programs of different anti-tumor drugs by matrix composed the ratio between the expected result and the cost;the patient-perspective value framework emphasizes the evaluation of the value of different healthcare intervention methods from the patient’s perspective;multiple criteria decision analysis advance value framework measures the value of drugs or measures from multiple dimensions. Combined with the characteristics of the above universal drug value evaluation tools and the correlation research of domestic drug value evaluation, the paper proposes to analyze the characteristics of Chinese patent medicine value evaluation from the six dimensions of effectiveness, safety, innovation, economy, suitability and accessibility of Chinese patent medicine, and expounds the strategy of constructing Chinese patent medicine value evaluation tool, so as to provide reference for the drug value evaluation and decision-making application of Chinese patent medicine.