The Economics of Comparative Effectiveness Studies Societal and Private Perspectives and their Implications for Prioritizing Public Investments in Comparative Effectiveness Research
The Economics of Comparative Effectiveness Studies Societal and Private Perspectives and their Implications for Prioritizing Public Investments in Comparative Effectiveness Research
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DOI：
10.2165/11539400-000000000-00000
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发表时间：
2010-01-01
影响因子：
4.4
通讯作者：
Conti, Rena
中科院分区：
文献类型：
--
作者：
Meltzer, David;Basu, Anirban;Conti, Rena
比较有效性研究（CER）可以为患者、提供者和支付者提供有价值的信息。为了最大限度地从CER的公共投资中获益，重要的是从这些利益相关者的角度理解CER的价值，以及这如何影响他们投资CER的动机。本文提供了一个评估CER的概念框架，并使用几个案例研究从多个角度说明了此类研究的潜在益处。我们研究了CER通过确定一种治疗何时当不同的亚组偏好不同的治疗时，当差异足够小，可以根据价格做出决定时，我们说明这些发现使用价值的信息技术来评估研究的价值，并通过检查药品价格的变化后出版的比较有效性研究。我们的研究结果表明，CER可能有很高的社会价值，但有限的私人回报提供者或付款人。我们还得出结论，信息价值工具可能有助于为政策决定提供信息，说明应向核证的排减量投资多少公共资金，以及如何优先使用可用于核证的排减量的公共资金，特别是将核证的排减量公共支出用于私人激励相对于社会效益而言较低的领域。
Comparative effectiveness research (CER) can provide valuable information for patients, providers and payers These stakeholders differ in their incentives to invest in CER. To maximize benefits from public investments in CER, it is important to understand the value of CER from the perspectives of these stakeholders and how that affects their incentives to invest in CER This article provides a conceptual framework for valuing CER, and illustrates the potential benefits of such studies from a number of perspectives using several case studies We examine cases in which CER provides value by identifying when one treatment is consistently better than others, when different treatments are preferred for different subgroups, and when differences are small enough that decisions can be made based on price. We illustrate these findings using value-of-information techniques to assess the value of research, and by examining changes in pharmaceutical prices following publication of a comparative effectiveness study. Our results suggest that CER may have high societal value but limited private return to providers or payers. This suggests the importance of public efforts to promote the production of CER We also conclude that value-of-information tools may help inform policy decisions about how much public funds to invest in CER and how to prioritize the use of available public funds for CER, in particular targeting public CER spending to areas where private incentives are low relative to social benefits