Assessments of the Value of New Interventions Should Include Health Equity Impact.
Assessments of the Value of New Interventions Should Include Health Equity Impact.
复制标题
对新干预措施价值的评估应包括健康公平影响。
DOI：
10.1007/s40273-022-01131-z
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发表时间：
2022-05
影响因子：
4.4
通讯作者：
Phillips KA
中科院分区：
文献类型：
--
作者：
Jansen JP;Trikalinos TA;Phillips KA
作为卫生技术评估的一部分，很少对新干预措施的卫生公平影响进行正式评估，以了解其价值。我们认为，这种情况应该改变。基于证据的健康公平影响的定量评估可以帮助决策者制定覆盖政策，方案设计和质量倡议，重点是在现有治疗方案的情况下优化总体健康和健康公平。我们概述了新的干预措施如何影响健康公平的概念基础，并采用基于决策分析模型的分布式成本效益分析来定量评估这一点，以美国FDA新批准的阿尔茨海默病药物（aducanumab）为例。我们认为，新干预措施的证据基础存在差距，例如，由于种族和少数民族群体的临床研究参与有限，并不排除这样的评估。了解这些不确定性对公平定价，决策和未来的研究都有影响。如果我们认真对待人口层面的决策，不仅注重改善总体健康，而且旨在改善健康公平，我们应该考虑定期评估新干预措施的健康公平影响。
A formal evaluation of the health equity impact of a new intervention is hardly ever performed as part of a health technology assessment to understand its value. This should change, in our view. An evidence-based quantitative assessment of the health equity impact can help decision makers develop coverage policies, programme designs, and quality initiatives focused on optimizing both total health and health equity given the treatment options available. We outline the conceptual basis of how a new intervention can impact health equity and adopt distributional cost-effectiveness analysis based on decision-analytic models to assess this quantitatively, using a newly US FDA-approved drug for Alzheimer’s disease (aducanumab) as an example. We argue that gaps in the evidence base for the new intervention, for example, due to limited clinical research participation among racial and ethnic minority groups, do not preclude such an evaluation. Understanding these uncertainties has implications for fair pricing, decision making, and future research. If we are serious about population-level decision making that not only is focused on improving total health but also aims to improve health equity, we should consider routinely assessing the health equity impact of new interventions.
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