Mathilde Puls MPH , James Horscroft PhD , Benjamin Kearns PhD , Daniel Gladwell PhD , Edward Church MSc , Kasper Johannesen PhD , Bill Malcolm MSc , John Borrill MSc
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引用次数: 0
摘要
目的:对将生命周期药物定价(LCDP)纳入成本效益分析(CEA)的现有方法进行综述,确定方法学方面的共同挑战,并提出在成本效益分析中前瞻性实施生命周期药物定价的建模方法:在 PubMed® 中进行了两次互补性检索,并结合人工搜索和参考文献挖掘,以确定探讨(1)药品价格如何随时间变化和(2)在成本效益模型(CEM)中应用动态定价的方法的英文全文文章。我们对相关文章进行了审阅,作者讨论了文献中使用的常见方法实践,以及在 CEM 中前瞻性地实施 LCDP 所面临的相关挑战。针对发现的每个关键挑战,我们都提出了解决该问题的建模建议:我们根据标题和摘要筛选了 1,200 项研究;对 117 项研究进行了资格审查,并在两次检索中纳入了 47 项研究。产品生命周期内的价格变化是复杂的、多因素的,在成本效益分析中应用 LCDP 的模型在方法上各不相同。我们发现了在 CEA 中建立 LCDP 模型所面临的四个主要挑战,包括如何建立失去排他性前后的价格趋势模型、如何捕捉价格变化对未来患者群的影响以及如何报告结果:准确量化 LCDP 的影响需要仔细考虑与药品价格演变以及如何在 CEA 中反映这些演变有关的多个方面。虽然仍存在不确定性,但我们的研究结果有助于在经济评估中实施和评估 LCDP。
Challenges of Incorporating Life Cycle Drug Pricing in Cost-Effectiveness Models: A Review of Methods and Modeling Suggestions
Objectives
This study aimed to conduct a review of existing methods used to incorporate life cycle drug pricing (LCDP) in cost-effectiveness analyses (CEAs), identify common methodological challenges, and suggest modeling approaches for prospectively implementing LCDP in CEA.
Methods
Two complementary searches were conducted in PubMed, combined with hand searching and reference mining, to identify English language full-text articles that explored (1) how drug prices change over time and (2) methods used to apply dynamic pricing in cost-effectiveness models (CEMs). Relevant articles were reviewed, and authors discussed the common methodological practices used in the literature and their associated challenges on prospectively implementing LCDP in CEMs. For each key challenge identified, we provide modeling suggestions to address the issue.
Results
We screened 1200 studies based on title and abstract; 117 were reviewed for eligibility, and 47 individual studies were included across both searches. Variations in prices over a product’s life cycle are complex and multifactorial, and models applying LCDP in CEA varied in their methodology. We identified 4 key challenges to modeling LCDP in CEA, including how to model price trends before and after loss of exclusivity, how to capture the effect of price changes on future patient cohorts, and how to report results.
Conclusion
Accurately quantifying the impact of LCDP requires careful consideration of multiple aspects pertaining to both the evolution of drug prices and how to reflect these in CEA. Although uncertainties remain, our findings can aid implementation and evaluation of LCDP in economic evaluations.
期刊介绍:
Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.