基于层次分析法的罕用药可及性

Accessibility of Orphan Drug Based on Analytic Hierarchy Process

目的探究影响罕用药可及性的关键指标,为提高药物可及性提供理论性参考和最佳决策。方法以药品可获得性、药品可负担性、合理用药作为罕用药可及性的一级评价指标,并细分指标构建完整的评价指标体系,运用层次分析法,通过指标间的两两比较进一步构建判断矩阵,借助Matlab、迈实AHP层次分析法工具计算指标权重,从而对评价指标进行重要度排序。结果药品可获得性的细分指标“有无适当药物被研发”对罕用药可及性的影响最大,所占权重达0.2108;而药品可负担性指标下的“患者家庭收入与药品价格比”和“基本医疗保险覆盖情况”对罕用药可及性的影响力分别以0.1880和0.1447的权重位列第2和第3。结论为提高目前国内罕用药可及性,解决罕见病患者难治疗、难支付等问题,我国可以从建立企业创新研发激励政策、完善药物审批注册机制、健全罕用药“1+N”多方共付的医疗保障制度这3个层面入手。

Objective To explore the key indicators that affect the availability of orphan drugs,and to provide theoretical references and optimal decisions for improving the availability of drugs.Methods The article uses drug availability,drug affordability,and rational drug use as the primary evaluation indicators for the accessibility of orphan drugs,and subdivides the indicators to build a complete evaluation indicator system,using Analytic Hierarchy Process(AHP)to pass the indicators The pairwise comparison between the two further constructs the judgment matrix,and calculates the index weight with the help of Matlab and Maishi AHP tools,so as to sort the importance of the evaluation index.Results The study found that the subdivision index of drug availability"whether appropriate drugs are developed"has the greatest impact on the accessibility of orphan drugs,with a weight of 0.2108;while the"patient family income and patient family income"under the drug affordability index The influence of"drug price ratio"and"basic medical insurance coverage"on the accessibility of orphan drugs ranked second and third with weights of 0.1880 and 0.1447,respectively.Conclusion In order to improve the current availability of orphan drugs in China and solve the problems of patients with rare diseases that are difficult to treat and pay,my country can start from establishing incentive policies for enterprise innovation and R&D,improving drug approval and registration mechanisms,and improving the“1+N”multi-party co-existence of orphan drugs.The paid medical security system starts with these three levels.