神經藥物經濟學

Neuropharmacoeconomics

邱浩彰(Hou-Chang Chiu)

《Acta Neurologica Taiwanica》 13卷2期 (2004/06) Pp. 87-96

https://doi.org/10.29819/ANT.200406.0008

摘要

藥物經濟學的定義是：描述及分析藥物的治療對整體醫療系統及社會大眾之成本及效益的影響。其重點在確認、測量、及比較成本（資源之消耗）及治療的結果。成本的計算很複雜，簡單可分為：疾病的成本與疾病治療的成本。每一種成本都有醫療與非醫療兩部分，治療結果是指藥物介入的結果，應該包括臨床上的結果、經濟上的結果與人性上的結果。治療結果有三種單位：效果、利益及效用，其各有各的指標與測量及計算方法。因此形成了藥物經濟學的四種主要的分析類型：成本效果分析(CEA)，成本利益分析(CBA)，成本最低分析(CMA)，及成本效用分析(CUA)。世界衛生組識為促進各種不同醫療照顧的公共衛生評估，在近年呼籲開發中及已開發國家的衛生機關重視神經疾病為重大的公共衛生問題。要評估成本效益性的問題，可用兩個指標來衡量即調整品質後存活人年(QALY)與失能調整後存活人年(DALY)來作為健康照顧的基本單位及國家的負擔。本文將介紹神經科常用藥物的藥物經濟學的討論。在藥物經濟學的觀點，如何計算不同的成本，如何提出假設，將複雜的情況簡化成較單純的情形再用量化的觀點計算出成本。故在一篇藥物經濟學的文章中，我們要了解其分析的主題、所提出的假說及所用的分析方法，方能了解文中所提供數字的意義。

關鍵字

藥物經濟學 ； 成本效果分析 ； 品質調整後存活人年(QALY) ； 失能調整後存活人年(DALY) ； 成本效用分析

並列摘要

Pharmacoeconomics is concerned with how to allocate drug resources among alternative uses efficiently and effectively. Economic evaluation is a set of formal quantitative methods to capture the outcomes and costs of alternate intervention strategies. There are four basic types of economic evaluations used to assess interventions, are classified on the basis of the outcomes employed: 1.Cost minimization (CMA) is the comparison of costs of alternative interventions when the outcomes are assumed to be equal or similar, and the control intervention has been established. 2.Cost-effectiveness (CEA) is appropriate when the health outcomes are measured in common physical units, such as death or disability, or years gained or increased function, or points on cognitive scales. 3.Cost utility (CUA) is an extension of cost-effectiveness, where different types of health outcomes are weighted according to assigned values of 'quality of life' to produce a composite of both the physical measurement and the value assigned to it, e.g. quality-adjusted life years (QALY) or disability-adjusted life years (DALY). A common denominator measure of effectiveness is thus the life years of expected survival, or the QALY. The global burden disease (GBD) researchers adopted an internationally standardized form of the QALY, which they called the DALY.A quality of life measure can be translated into a scale that ranges from a low of 0.0 (the worst possible health state, usually taken as death) to 1.0 (perfect health). The purpose is to make explicit the measurement of costs and value assigned to benefits. 4.Cost-benefit (CBA) analysis value health outcomes in monetary terms, often based on the concept of 'willingness to pay'. The common drugs used by the neurologists had been discussed in this article based on the point view of pharmacoeconomics.

並列關鍵字

Pharmacoeconomics ； Cost-effectiveness analysis ； QALY ； DALY ； Cost-utility analysis