{"title":"比利时、苏格兰和瑞典抗癌药物使用差异的决定因素。","authors":"Alessandra Ferrario","doi":"10.1007/s10198-016-0855-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Little comparative evidence is available on utilisation of cancer medicines in different countries and its determinants. The aim of this study was to develop a statistical model to test the correlation between utilisation and possible determinants in selected European countries.</p><p><strong>Methods: </strong>A sample of 31 medicines for cancer treatment that obtained EU-wide marketing authorisation between 2000 and 2012 was selected. Annual data on medicines' utilisation covering the in- and out-patient public sectors were obtained from national authorities between 2008 and 2013. Possible determinants of utilisation were extracted from HTA reports and complemented by contacts with key informants. A longitudinal mixed effect model was fitted to test possible determinants of medicines utilisation in Belgium, Scotland and Sweden.</p><p><strong>Results: </strong>In the all-country model, the number of indications reimbursed positively correlated with increased consumption of medicines [one indication 2.6, 95% CI (1.8-3.6); two indications 2.4, 95% CI (1.4-4.3); three indications 4.9, 95% CI (2.2-10.9); all P < 0.01], years since EU-wide marketing authorisation [1.2, 95% CI (1.02-1.4); p < 0.05], price per DDD [0.9, 95% CI (0.998-0.999), P < 0.01], and Prescrire rating [0.5, 95% CI (0.3-0.9), P < 0.05] after adjusting for time and other covariates.</p><p><strong>Conclusions: </strong>In this study, the most important correlates of increased utilisation in a sample of cancer medicines introduced in the past 15 years were: medicines coverage and time since marketing authorisation. Prices had a negative effect on consumption in Belgium and Sweden. The positive impact of financial MEAs in Scotland suggests that the latter may remove the regressive effect of list prices on consumption.</p>","PeriodicalId":17109,"journal":{"name":"Journal of Testing and Evaluation","volume":"48 1","pages":"1095-1105"},"PeriodicalIF":0.8000,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641289/pdf/","citationCount":"0","resultStr":"{\"title\":\"Determinants of utilisation differences for cancer medicines in Belgium, Scotland and Sweden.\",\"authors\":\"Alessandra Ferrario\",\"doi\":\"10.1007/s10198-016-0855-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Little comparative evidence is available on utilisation of cancer medicines in different countries and its determinants. The aim of this study was to develop a statistical model to test the correlation between utilisation and possible determinants in selected European countries.</p><p><strong>Methods: </strong>A sample of 31 medicines for cancer treatment that obtained EU-wide marketing authorisation between 2000 and 2012 was selected. Annual data on medicines' utilisation covering the in- and out-patient public sectors were obtained from national authorities between 2008 and 2013. Possible determinants of utilisation were extracted from HTA reports and complemented by contacts with key informants. A longitudinal mixed effect model was fitted to test possible determinants of medicines utilisation in Belgium, Scotland and Sweden.</p><p><strong>Results: </strong>In the all-country model, the number of indications reimbursed positively correlated with increased consumption of medicines [one indication 2.6, 95% CI (1.8-3.6); two indications 2.4, 95% CI (1.4-4.3); three indications 4.9, 95% CI (2.2-10.9); all P < 0.01], years since EU-wide marketing authorisation [1.2, 95% CI (1.02-1.4); p < 0.05], price per DDD [0.9, 95% CI (0.998-0.999), P < 0.01], and Prescrire rating [0.5, 95% CI (0.3-0.9), P < 0.05] after adjusting for time and other covariates.</p><p><strong>Conclusions: </strong>In this study, the most important correlates of increased utilisation in a sample of cancer medicines introduced in the past 15 years were: medicines coverage and time since marketing authorisation. Prices had a negative effect on consumption in Belgium and Sweden. The positive impact of financial MEAs in Scotland suggests that the latter may remove the regressive effect of list prices on consumption.</p>\",\"PeriodicalId\":17109,\"journal\":{\"name\":\"Journal of Testing and Evaluation\",\"volume\":\"48 1\",\"pages\":\"1095-1105\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2017-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641289/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Testing and Evaluation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s10198-016-0855-5\",\"RegionNum\":4,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2016/12/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"MATERIALS SCIENCE, CHARACTERIZATION & TESTING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Testing and Evaluation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s10198-016-0855-5","RegionNum":4,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2016/12/9 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"MATERIALS SCIENCE, CHARACTERIZATION & TESTING","Score":null,"Total":0}
引用次数: 0
摘要
背景:关于不同国家癌症药物使用情况及其决定因素的比较证据很少。本研究旨在建立一个统计模型,以测试选定欧洲国家的使用率与可能的决定因素之间的相关性:方法:选取 2000 年至 2012 年期间在欧盟范围内获得上市许可的 31 种癌症治疗药物作为样本。2008 年至 2013 年期间,从各国政府部门获得了涵盖住院和门诊公共领域的年度药物使用数据。从 HTA 报告中提取了药物使用的可能决定因素,并通过与关键信息提供者的接触加以补充。我们建立了一个纵向混合效应模型,以检验比利时、苏格兰和瑞典药品使用情况的可能决定因素:在所有国家的模型中,报销适应症的数量与药品消费量的增加呈正相关[一个适应症 2.6,95% CI (1.8-3.6);两个适应症 2.4,95% CI (1.4-4.3);三个适应症 4.9,95% CI (2.2-10.9);所有 P 结论:在这项研究中,在过去 15 年中推出的癌症药物样本中,使用率增加的最重要相关因素是:药品覆盖率和上市授权时间。在比利时和瑞典,价格对用药量有负面影响。苏格兰的财政多边环境协定产生了积极影响,这表明后者可以消除清单价格对消费的倒退效应。
Determinants of utilisation differences for cancer medicines in Belgium, Scotland and Sweden.
Background: Little comparative evidence is available on utilisation of cancer medicines in different countries and its determinants. The aim of this study was to develop a statistical model to test the correlation between utilisation and possible determinants in selected European countries.
Methods: A sample of 31 medicines for cancer treatment that obtained EU-wide marketing authorisation between 2000 and 2012 was selected. Annual data on medicines' utilisation covering the in- and out-patient public sectors were obtained from national authorities between 2008 and 2013. Possible determinants of utilisation were extracted from HTA reports and complemented by contacts with key informants. A longitudinal mixed effect model was fitted to test possible determinants of medicines utilisation in Belgium, Scotland and Sweden.
Results: In the all-country model, the number of indications reimbursed positively correlated with increased consumption of medicines [one indication 2.6, 95% CI (1.8-3.6); two indications 2.4, 95% CI (1.4-4.3); three indications 4.9, 95% CI (2.2-10.9); all P < 0.01], years since EU-wide marketing authorisation [1.2, 95% CI (1.02-1.4); p < 0.05], price per DDD [0.9, 95% CI (0.998-0.999), P < 0.01], and Prescrire rating [0.5, 95% CI (0.3-0.9), P < 0.05] after adjusting for time and other covariates.
Conclusions: In this study, the most important correlates of increased utilisation in a sample of cancer medicines introduced in the past 15 years were: medicines coverage and time since marketing authorisation. Prices had a negative effect on consumption in Belgium and Sweden. The positive impact of financial MEAs in Scotland suggests that the latter may remove the regressive effect of list prices on consumption.
期刊介绍:
This journal is published in six issues per year. Some issues, in whole or in part, may be Special Issues focused on a topic of interest to our readers.
This flagship ASTM journal is a multi-disciplinary forum for the applied sciences and engineering. Published bimonthly, the Journal of Testing and Evaluation presents new technical information, derived from field and laboratory testing, on the performance, quantitative characterization, and evaluation of materials. Papers present new methods and data along with critical evaluations; report users'' experience with test methods and results of interlaboratory testing and analysis; and stimulate new ideas in the fields of testing and evaluation.
Major topic areas are fatigue and fracture, mechanical testing, and fire testing. Also publishes review articles, technical notes, research briefs and commentary.