医院中具有成本效益和可持续的药物使用：系统和基于实践的方法。

IF 3.1 4区医学 Q1 ECONOMICS

Applied Health Economics and Health Policy Pub Date : 2024-12-19 DOI:10.1007/s40258-024-00937-6

Michiel Zietse, Shannon L. van der Zeeuw, Anne-Sophie Klein Gebbink, Annemarie C. de Vries, Marie-Rose B. S. Crombag, Roelof W. F. van Leeuwen, Maaike J. Hoedemakers

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引用次数: 0

摘要

背景与目的：不断上升的医疗成本对医疗系统的财务可持续性提出了挑战。介入药物经济学已成为提高临床实践中药物成本效益和可持续使用的重要学科。然而，目前的努力往往是分散的，这突出表明需要采取全医院的综合办法。本研究旨在开发一个可扩展的框架，以系统地确定和实施具有成本效益和可持续的医院用药做法。方法：本研究于2022年12月至2023年7月在鹿特丹伊拉斯谟大学医学中心进行。设计了一个新的“8步效率模型”，以系统地确定和评估具有成本效益和可持续的药物使用战略。该过程包括确定高支出药物，使用效率模型系统地评估这些药物，并对拟议的成本效益战略进行多学科评估。结果：该研究评估了39种高成本药物，占2021年荷兰国家昂贵药物支出的57%。为39种评估药物中的27种（占2021年国家药物支出的51%）确定或制定了提高成本效益和可持续性的举措。英夫利昔单抗（例如，预防浪费）和静脉注射免疫球蛋白（例如，瘦体重剂量）的案例说明了该框架的实际应用，从而节省了大量成本并提高了可持续性。结论：本研究提出了一个系统的可扩展模型，以提高医院环境中高费用药物的成本效益。这种方法不仅解决了财务可持续性问题，而且还促进了患者护理质量和可持续用药。这一模式可作为其他机构确定和执行具有成本效益和可持续的药物使用战略的通用蓝图。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Cost-Effective and Sustainable Drug Use in Hospitals: A Systematic and Practice-Based Approach

Background and Objective

Rising healthcare costs challenge the financial sustainability of healthcare systems. Interventional pharmacoeconomics has emerged as a vital discipline to improve the cost-effective and sustainable use of drugs in clinical practice. However, current efforts are often fragmented, highlighting the need for an integrated hospital-wide approach. This study aimed to develop a scalable framework to systematically identify and implement cost-effective and sustainable drug use practices in hospitals.

Methods

This study was conducted at the Erasmus University Medical Centre in Rotterdam between December 2022 and July 2023. A novel ‘8-Step Efficiency Model’ was designed to systematically identify and evaluate strategies for cost-effective and sustainable drug use. The process involved identifying high-expenditure drugs, systematically assessing these drugs using the Efficiency Model, and conducting a multi-disciplinary evaluation of the proposed cost-effectiveness strategies.

Results

The study assessed 39 high-cost drugs, representing 57% of the Dutch national expensive drug expenditure in 2021. Initiatives for enhancing cost-effectiveness and sustainability were identified or developed for 27 out of the 39 assessed drugs (51% of the national drug expenditure in 2021). Case examples of infliximab (e.g., wastage prevention) and intravenous immunoglobulins (e.g., lean body weight dosing) illustrate practical applications of the framework, resulting in substantial cost savings and improved sustainability.

Conclusions

This study presents a systematic scalable model for enhancing the cost-effectiveness of high-expenditure drugs in hospital settings. This approach not only addresses financial sustainability but also promotes the quality of patient care and sustainable drug use. This model could serve as a generic blueprint for other institutions to identify and implement cost-effective and sustainable drug use strategies.

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来源期刊

Applied Health Economics and Health Policy Economics, Econometrics and Finance-Economics and Econometrics

CiteScore

6.10

自引率

2.80%

发文量

期刊介绍： Applied Health Economics and Health Policy provides timely publication of cutting-edge research and expert opinion from this increasingly important field, making it a vital resource for payers, providers and researchers alike. The journal includes high quality economic research and reviews of all aspects of healthcare from various perspectives and countries, designed to communicate the latest applied information in health economics and health policy. While emphasis is placed on information with practical applications, a strong basis of underlying scientific rigor is maintained.