我国药物经济学成本-效果阈值测算方法的选择与数据获取方法研究

Research on the Selection of Cost-effectiveness Threshold Calculation Methods and Data Acquisition Methods of Pharmacoeconomics in China

目的:为我国药物经济学成本-效果阈值测算方法的选择和数据获取方法提供借鉴经验,以期我国在医保准入中设定合适的阈值参考范围,将真正具有经济性的药物纳入医保目录。方法:通过搜集整理现有成本-效果阈值测算方法的优劣势,结合国内外医保基金预算的灵活程度、数据获取的途径、类型和测算方法的选择,试图寻找适合我国的阈值测算方法和数据获取方法。结果:我国的医保基金预算的灵活度不高且具有医保控费的压力,适宜选择机会成本法,但该方法数据获取难度较大,为提高该方法测算结果的可靠性,英国还通过ICD-10代码对疾病进行分类获取数据,在当前数据获取难度较大的情况下,有操作性较强的意愿支付法或人均国内生产总值(Gross Domestic Product,GDP)法可供选择。结论:我国适宜选择机会成本法,在当前数据获取难度较大的情况下,建议选择意愿支付法或人均GDP法测得阈值作为参考。

Objective:To provide references for the selection of cost-effectiveness threshold calculation methods and data acquisition methods for pharmacoeconomics in China,so as to set an appropriate threshold reference range in medical insurance access and to include truly economical drugs in the medical insurance catalog.Methods:By collecting and sorting out the advantages and disadvantages of the existing costeffectiveness threshold calculation methods,combining with the flexibility of domestic and foreign medical insurance fund budgets,it is tried to find ways and types of data acuisitin,the choice of calculation methods,a threshold calculation method and data acquisition method suitable for your country.Results:Medical insurance fund budget in our country is not flexible and has the pressure of medical insurance cost control.It is advisable to choose the opportunity cost method,although it is difficult to obtain data.In order to improve the credibility of the calculation results of this method,the UK also classifies diseases to obtain data through ICD-10 code,in the current situation where data acquisition is difficult,willingness to pay method or per capita GDP method with strong operability could be selected.Conclusion:It is appropriate to choose the opportunity cost method in our country.In the current situation where data acquisition is difficult,it is recommended to choose the threshold measured by the willingness to pay method or the per capita GDP method as a reference.