Measuring and Incorporating Financial Protection into Economic Evaluation in Health Care

每年，数以百万计的人因为昂贵的疾病而遭受经济困难。在发展中国家，支付护理费用往往会使家庭陷入贫困。这在发达国家也是一个重要的问题。在英国，英国国家医疗服务体系拒绝了患者购买昂贵药物的要求，如果他们选择购买，就必须自己支付整个治疗费用。NHS根据来自国家临床卓越研究所(NICE)的成本效益证据证明这些决定是合理的。通过成本效益，NICE意味着患者的健康收益应该大于NHS的治疗成本，从而证明纳税人的资金是合理的。虽然大多数人会同意，防止昂贵治疗带来的困难也是一种有价值的收益，但目前成本效益分析中没有考虑这种价值。伦敦帝国理工学院的罗德里戈·莫雷诺-塞拉博士领导的这项研究调查了如何修改成本效益分析方法，以包括预防昂贵疾病的好处。它将使用来自不同国家的数据来衡量风险保护效益，并评估当计入这些效益时，昂贵治疗的成本效益数字将如何变化。这项研究可能会改变政府和NICE等机构对高成本治疗的看法。

Each year millions of people suffer financial hardship because of expensive illnesses. In developing countries, paying for care often makes families fall into poverty. This is an important issue also in developed countries. In the UK patients have had their requests for expensive medicines denied by the NHS, having to pay for the whole treatment themselves if they choose to buy them. The NHS justifies such decisions based on cost-effectiveness evidence from the National Institute for Clinical Excellence (NICE). By cost-effective, NICE means that the health benefits for the patient should be larger enough than treatment costs for the NHS to justify taxpayer‘s funding.While most people would agree that protection against hardship from expensive treatments is a valuable benefit too, such value is not currently considered in cost-effectiveness analyses. The research led by Dr Rodrigo Moreno-Serra at Imperial College London investigates how methods of cost-effectiveness analysis could be modified to include benefits of protection against expensive illnesses. It will use data from different countries to measure risk protection benefits, and assess how cost-effectiveness figures for expensive treatments change when these benefits are included. This research may change the way high-cost treatments are regarded by governments and agencies like NICE.