Methods of international health technology assessment agencies for economic evaluations--a comparative analysis.
Methods of international health technology assessment agencies for economic evaluations--a comparative analysis.
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DOI：
10.1186/1472-6963-13-371
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发表时间：
2013-09-30
影响因子：
2.8
通讯作者：
Pieper D
中科院分区：
文献类型：
--
作者：
Mathes T;Jacobs E;Morfeld JC;Pieper D
卫生技术评估（HTA）机构的数量增加。卫生技术协定的一个组成部分是经济方面。为了纳入经济方面，通常进行经济评估。国际卫生技术评估机构之间关于卫生经济评估方法的建议的趋同将有助于结果适应不同的环境，并避免不必要的费用。这方面的第一步是详细分析各项建议中现有的相同点和不同点，以确定统一的可能性。其目的是提供一个概述和比较的方法建议的国际卫生技术评估机构的经济评估。对127个国际卫生技术评估机构的网页进行了搜索，以寻找关于编制经济评估方法的建议。此外，还要求卫生技术评估机构提供关于经济评估方法的信息。根据13个方法学方面，在标准化表格中摘录了所列准则的建议。所有工艺步骤均由两名审查员独立执行。最后，14个卫生技术评估机构的25篇出版物被纳入分析。经济评价的方法差别很大。分析类型和比较器的一致性最高。建议进行成本效用分析或成本效益分析。比较者应继续进行常规护理。在关于影响的衡量/来源、贴现和敏感性分析的建议方面也显示出最大的差异。关于效果的主要区别是关注功效或有效性。建议的贴现率范围为1.5% - 5%的影响和3% - 5%的成本，其中大多数建议使用相同的利率的成本和影响。关于敏感性分析，主要区别在于，通常只建议采用概率或确定性方法。建模的方法只是含糊地描述，主要是合理的“适当的模型”取决于决策问题。考虑到所有其他方面，比较是具有挑战性的，因为建议的详细程度和解决的问题各不相同。在建议中有相当大的无法解释的差异。需要进一步努力统一经济评价的编制方法。
The number of Health Technology Assessment (HTA) agencies increases. One component of HTAs are economic aspects. To incorporate economic aspects commonly economic evaluations are performed. A convergence of recommendations for methods of health economic evaluations between international HTA agencies would facilitate the adaption of results to different settings and avoid unnecessary expense. A first step in this direction is a detailed analysis of existing similarities and differences in recommendations to identify potential for harmonization. The objective is to provide an overview and comparison of the methodological recommendations of international HTA agencies for economic evaluations. The webpages of 127 international HTA agencies were searched for guidelines containing recommendations on methods for the preparation of economic evaluations. Additionally, the HTA agencies were requested information on methods for economic evaluations. Recommendations of the included guidelines were extracted in standardized tables according to 13 methodological aspects. All process steps were performed independently by two reviewers. Finally 25 publications of 14 HTA agencies were included in the analysis. Methods for economic evaluations vary widely. The greatest accordance could be found for the type of analysis and comparator. Cost-utility-analyses or cost-effectiveness-analyses are recommended. The comparator should continuously be usual care. Again the greatest differences were shown in the recommendations on the measurement/sources of effects, discounting and in the analysis of sensitivity. The main difference regarding effects is the focus either on efficacy or effectiveness. Recommended discounting rates range from 1.5% - 5% for effects and 3% - 5% for costs whereby it is mostly recommended to use the same rate for costs and effects. With respect to the analysis of sensitivity the main difference is that oftentimes the probabilistic or deterministic approach is recommended exclusively. Methods for modeling are only described vaguely and mainly with the rational that the “appropriate model” depends on the decision problem. Considering all other aspects a comparison is challenging as recommendations vary regarding detailedness and addressed issues. There is a considerable unexplainable variance in recommendations. Further effort is needed to harmonize methods for preparing economic evaluations.
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DOI：
10.1017/s0266462305050221
发表时间：
2005-03-01
影响因子：
3.2
作者：
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发表时间：
2008-06-01
影响因子：
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