定价空间缺失问题:肿瘤新药经济性评价中的一种常见“困境”

The Lack of Pricing Space:A"Dilemma"in Economic Evaluation of New Antitumor Drugs

目的:解析肿瘤新药经济学评价经常出现的药品定价空间缺失问题的成因并探讨解决方法。方法:基于理论分析和案例剖析,分析肿瘤新药经济学评价中研究组和对照组成本和健康产出的组成内容、差异的来源和经济性评价的标准,从而探寻导致新药定价空间受限的原因。结果:肿瘤新药经济性评价中主要存在健康产出(QALYs)、用药费用和延长生存期间增加的医疗费用三方面因素,如果延长生存所消耗的医疗费用过高,研究组增量接近或超过QALYs货币价值增量,则新药费用空间受限,导致新药定价空间缺失。结论:肿瘤患者延长生存时间的代价是巨大的资源消耗,要使新药具有定价空间,则必须提高健康支付意愿或减少肿瘤治疗的资源消耗。

Objective:The paper analyzes the reason of lack of pricing space in economic evaluation of new antitumor drugs and explores the solutions.Methods:Based on theoretical analysis and case study,the paper analyzes the contents of cost and health outcome for the study group and control group,the sources of difference between groups and the criteria for economic evaluation in economic evaluation of new antitumor drugs,to explore the reason of lack of pricing space for new drugs.Results:Health outcome(QALYs),expenditure of drugs,and medical expense for prolonging patients’life are keys for economic evaluation.If incremental medical expense for prolonging patients’life was too high,and the increment of the study group approaches or exceeds the monetary value increment of QALYs,the space for new drug costs is limited,resulting in a lack of pricing space for new drugs.Conclusion:The cost of prolonging the survival time of patients with tumor is the huge resource consumption.In order to give new drugs pricing space,it is necessary to increase the willingness to pay for health or reduce the resource consumption of tumor treatment.