中药药物经济学评价问题研究

药物经济学是经济学原理与方法在药品领域内的具体运用,它将经济学基本原理、方法和分析技术运用于临床药物治疗过程,并以药物流行病学的人群观为指导,从全社会角度开展研究,以求最大限度地合理利用现有医药卫生资源。药物经济学评价方法现已广泛应用于化学药的评价,但由于药物经济学理论的发源和兴起都在西方发达国家,加之中药组分、成分的复杂性,以及评价结果的不准确性,中药的药物经济学评价研究目前尚处于起步阶段。在新实施的《国家基本药物目录》中,中药及中药饮品占目录的三分之一。由此可见,在我国,了解中药的经济性,保证药品目录遴选的合理性,公平分配利用卫生资源是     

药物经济学的进展

药物经济学 (ｐｈａｒｍａｃｏｅｃｏｎｏｍｉｃ ,ＰＥ)是 70年代发展起来的一门新兴边缘学科 ,它是将经济学原理和方法应用于评价临床药物治疗过程 ,并以指导医生制订合理的费用效果处方为宗旨的应用科学。核心是通过优化成本—效果结构来提高治疗效率 ,最大限度地提高患者的生活质量 ,通过降低发病率和降低医疗需求来达到控制药品费用增长的目的。近年来我国医疗费用每年以 30 %的速度增长 ,远远超过了国内生产总值 10 %左右的增长速度 ,其中药物的费用问题已成为全社会关注的热点。在此情形下 ,近年开展了一些ＰＥ的研究。1　开展药物经…     

肠外与肠内营养药费用分析

药品作为一种防病治病的商品,它不仅有着本身特有的属性,也有其相应的经济学品性,因此药物经济学不仅需要从微观经济学的角度,研究不同药品的需求和供给问题,以及对临床主要药物治疗的成本效益和成本效果进行评价;此外,药物经济学也需要从宏观角度,对一个国家和地区的药品总费用、结构及其分配流向进行研究,分析导致药品费用增长的主要因素。这些内容的研究对于保障居民对药品的可及性,促进药品合理应用以及控制药品费用的不合理增长都是至关重要的。     

浅谈药物经济学的应用

对近年来药物经济学的应用情况进行概述。药物经济学在更新药物评价观念 ,指导合理用药 ,新药开发、老药评价 ,完善药疗方案 ,控制药品费用等方面得到很好的应用。认为应用药物经济学可做到以最低的费用获取最佳医疗效果     

药物经济学研究进展

药物经济学 (ｐｈａｒｍａｃｏｅｃｏｎｏｍｉｃｓ,ＰＥ)是以卫生经济学为基础而建立起来的一门新兴应用学科。它将经济学原理和方法应用于对临床药物的治疗过程及结果的评价。对临床治疗方案的确定、药品资源的优化配置、新药研制、医疗保险、药政管理等提供决策依据有重大意义。1　药物经济学的主要任务1 1　在卫生成本中 ,药品费用一般占有较大的比重 (2 0 %以上 )。我国的卫生经费十分有限 ,而且药费比例又特别大。因此 ,药物经济学有特别重要的地位。通过分析各种药物治疗模式的成本和效益情况 ,目的在于优化卫生资源的使用 ,并非单纯…     

药物经济学的研究方法及应用

药物经济学是以卫生经济学为基础而建立发展的一门新型边缘学科。它将经济学的基本原理、方法和分析技术运用于临床治疗过程，从而合理分配和使用有限的卫生资源和医疗经费，使药物安全、有效、经挤地为病人服务。进行分析耐的关键步骤包括：详细、具体地阐明研究目的，明确要比较的不同方案和求得每一项的成本及结果。章重点介绍了目前几种常用的药物经济学研究方法，包括成本分析、最小成本分析、成本效果分析、成本效用分析和成本效益分析，为药物经济学研究的实际应用提供参考。     

四种用药方案控制COPD肺部感染的最小成本分析

目的：对4种抗茵药物治疗COPE）肺部感染进行药物经济学评价，为医师用药提供科学依据，促进临床更合理规范地使用抗菌药物。方法：采用回顾性研究方法，抽取2007年1月-2009年4月呼吸科COPD病例，应用最小成本分析法进行药物经济学评价。结果：在COPD组中，4种治疗方案疗效无显著性差异（P〉0．05），但成本存在显著性差异（P〈0．05）。结论：对于控制COPD肺部感染，A方案经济效果明显优于其他方案。     

2种抗菌药物治疗泌尿系感染方案的成本-效果分析

目的：评价2种治疗方案的药物经济学效果。方法：运用药物经济学成本-效果分析法对2种泌尿系感染治疗方案,即A、B方案进行分析评价。结果：B方案为最佳方案。结论：通过分析,说明了药物经济学在优化治疗方案、指导合理用药、提高经济效益方面具有重要作用。     

药物经济学在合理用药中的应用

<正>药物经济学是经济学原理与方法在药品领域内的具体运用。有广义和狭义之分,广义的药物经济学(pharmaceuticaleconomics)主要研究药品供需方的经济行为,供需双方相互作用下的药品市场定价,以及药品领域的各种干预政策措施等。狭义的药物经济学(pharmacoeconomics,PE)是一门将经济学基本原理,方法和分析技术运用于临床药物治疗过程,并以药物流行病学的人群观为指导,从全社会角度展开研究,以求最大限度的合理利用现有医药卫生资源的综合性应用科     

谈卫生经济学观点在临床中应用

随着现代医疗技术的迅速发展 ,医疗质量不断提高 ,但也使医疗费用急剧增长 ,国家和个人都面临着医疗费用的沉重负担。如何“花少钱”而“治好病” ,是一个急待解决的问题。近年来提出的卫生经济学 ,或称药品经济学分析 ,就是企图使这一问题得到合理解决的一个重点研究课题。一、概念所谓“卫生经济学” ,其目的是要用科学的方法 ,研究如何保证人民健康和卫生保健体制的财经稳定。应用其观点 ,临床医生不仅要知道如何合理应用日益增多的诊疗手段和药品 ,还应学会用经济分析的方法 ,提供医疗决策 ,从病人近期和长远的健康利益出发 ,选择相对最…     

Guideline for Postmarketing Chinese Medicine Pharmacoeconomic Evaluation

Pharmacoeconomics is an important part of the postmarketing Chinese medicine (CM) evaluation, and postmarketing pharmacoeconomic evaluation can reveal the clinical and market value of CM. The purpose of establishing the guideline for pharmacoeconomic evaluation is to make the evaluation process and results regarding Chinese patent medicines both scientific and fair. Every country''s guidelines for pharmacoeconomic evaluation act as reference guidelines, we have already drawn up the guideline that takes into account the special characteristics of CM; and these are in preparation for the postmarketing CM pharmacoeconomic evaluation.     

药物经济学研究设计与分析方法

选择适宜的设计与分析方法是药物经济学研究成败的关键。药物经济学研究设计方法主要有前瞻性研究设计、回顾性研究设计、模型法研究设计及混合研究设计四种。药物经济学分析中要注意成本研究,效果研究和效用研究。     

Pharmacoeconomics

Pharmacoeconomics focuses on the costs and benefits of drug therapy and pharmacoeconomic evaluations provide a basis for resource allocation and utilization. It is increasingly becoming important for health policy decision-making. A pharmacoeconomic evaluation may be conducted as an economic assessment incorporated into clinical trials. Such trials should compare the new drug/procedure with an older drug or existing intervention. Four techniques are used for economic evaluation, namely, cost-minimization analysis, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. The choice of the evaluation method depends on the nature of outcomes and the context in which the choices need to be made. Pharmacoeconomics is a young science that will improve with application. Its need is undeniable, especially in developing countries.     

A prototype computer decision support system for the management of asthma

Asthma is a chronic disease estimated to affect 6–7% of the total UK population. In addition, a number of studies have shown that asthma has become commoner since the 1970s, especially in children. The diagnosis of asthma can be difficult and its management requires the involvement of patients in a long-term treatment plan, something which general practitioners may be unable to achieve easily in the average 10-min consultation. As a consequence, asthma is underdiagnosed and undertreated. Deaths from the disease are often avoidable with timely and sufficient use of the available medication.^(3,4) In order to support this, the British Thoracic Society (BTS) has published guidelines for asthma management based upon a stepwise approach, in which a patient is categorized as being on one of five steps according to the severity of his or her asthma. The guidelines give “rules of thumb” for deciding when the patient should move up or down the steps. The most recent version of the guidelines also included special rules for children.^(5,6) Within a recent European Community project on Advanced Informatics in Medicien (AIM), we developed a prototype decision support system for asthma management targeted at the primary care setting and based on the British Thoracic Society guidelines. This paper reports this development, and describes the further work needed on the prototype. Plans for evaluation of the knowledge bases and for future full application production are also described.     

Report on activities and attitudes of organizations active in the clinical practice guidelines field.

The organizing committee of a workshop on clinical practice guidelines (CPGs) surveyed invited organizations on their attitudes and activities related to five topics to be covered during the workshop sessions: organizational roles, priority setting, guidelines implementation, guidelines evaluation and development of a network of those active in the CPG field. Organizational roles: The national specialty societies were felt to have the largest role to play; the smallest roles were assigned to consumers, who were seen to have a role mainly in priority setting, and to industry and government, both of which were seen to have primarily a funding role. Many barriers to collaboration were identified, the solutions to all of which appeared to be better communication, establishment of common principles and clear role definitions. Priority setting: There was considerable agreement on the criteria that should be used to set priorities for CPG activities: the burden of disease on population health, the state of scientific knowledge, the cost of treatment and the economic burden of disease on society were seen as important factors, whereas the costs of guidelines development and practitioner interest in guidelines development were seen as less important. Organizations were unable to give much information on how they set priorities. Guidelines implementation: Most of the organizations surveyed did not actively try to ensure the implementation of guidelines, although a considerable minority devoted resources to implementation. The 38% of organizations that implemented guidelines actively listed a wide variety of activities, including training, use of local opinion leaders, information technology, local consensus processes and counter detailing. Guidelines evaluation: Formal evaluation of guidelines was undertaken by fewer than 13% of the responding organizations. All the evaluations incorporated assessments before and after guideline implementation, and some used primary patient data. Barriers to evaluation included lack of money, time, data or expertise. CPG Network: Most of the respondents felt that all organizations and individuals interested or involved in guidelines should form the membership of the network. The three most important functions of such a network were deemed to be (a) to facilitate collaboration among those involved in the CPG process, (b) to maintain an information centre on CPGs and (c) to provide expertise to the CPG process. It was felt that the network should have some formal structure and communicate through e-mail and print media.     

国际临床指南评价工具的发展与启示

以22个指南评价工具为研究对象,分析了国际临床指南评价工具的出台背景和特点、维度和条目内容,介绍了国外临床指南评价工具的发展历程,演变过程、发展规律和存在的问题,为开发本土化的临床指南评价工具提供依据。研究发现指南评价工具出现明显分类;指南评价工具正力求在全面性和实用性之间达到平衡;现有评价工具对指南的临床内容评价不足,评分系统有待改进;指南评价应越来越多地考虑价值取向与利益冲突,考虑病人的意向与参与。     

Health promotion--caring concern or slick salesmanship?

There is an increasing tendency for administrators and government to expect both the health services and the education service to 'show results' for the investment of public money in them. One response to this has been the growing commitment to 'health promotion', where measurable objectives may be set in terms of desired behaviour (stopping smoking, breast self-examination, child immunisation etc) and where evaluation can be made on the evidence of statistical improvement. Health workers use the term 'promotion' in a variety of ways which seem to be as confusing to them as they are to their clients --the general public. Since successful promotion is likely to depend on the 'hard sell' (and since the methodology and aims of this may be incompatible with those of health education) this paper looks at some of the questions which the customer might wish to ask the salesman before deciding whether or not to buy.     

3种方案治疗非淋菌性尿道（宫颈）炎的决策树分析

目的：评价3种方案治疗非淋菌性尿道（宫颈）炎的经济学效果。方法：运用药物经济学决策树分析原理,分别对左氧氟沙星序贯疗法、阿奇霉素静脉滴注疗法和依诺沙星静脉滴注疗法进行回顾性分析、评价。结果：3种治疗方案的总成本依次为114.60、474.53和379.33元,总有效率为86.20%、88.35%和87.50%。每治愈1例非淋菌性尿道（宫颈）炎患者所期望的成本分别为132.95、537.10和433.52元。结论：3种治疗方案中以左氧氟沙星序贯疗法为优。     

应用RAND—UCLA共识法制定腰痛转诊指征的实践研究

目的探讨兰德公司-美国加利福尼亚大学洛杉矶分校（RAND-UCLA）专家共识法在制订腰痛转诊指南中的有效性。方法运用多种检索工具查找2001年以来发表的有关社区腰痛管理的循证临床指南、转诊指南等文献,对符合入选标准的临床指南用指南研究与评价工具（AGREE）进行评价;基于循证建立转诊指征条目池。采用RAND—UCLA共识法补充、筛选备选指征,制订腰痛转诊指征。结果纳入经严格评价认可的可供参考的9个国家和地区的腰痛管理指南15个和2个国家的腰痛转诊指南4个。运用RAND-UCLA共识法两轮专家咨询,完成了立即、尽快和常规转诊三组腰痛44条转诊指征的制订。结论RAND-UCLA共识法在制订临床指南、转诊指南中更实用,值得推广。