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首页> 外文期刊>The Open Complementary Medicine Journal >Contingent Valuation of Eight New Treatments: What is the Clinician'sand Politician's Willingness to Pay?
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Contingent Valuation of Eight New Treatments: What is the Clinician'sand Politician's Willingness to Pay?

机译：八种新疗法的或有评估：临床医生和政客的付款意愿是什么？

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Objective: To assess the willingness to pay (WTP) for eight new treatments from a life-long perspective.Methods: A contingent valuation with virtual examples and dichotomous choice questions is circulated to Finnishclinicians (N 146) and politicians (N 73). Costs and utilities (15D, EQ-5D) are obtained from Finnish sources, and thehealth care payer perspective is assumed. Health benefits are measured using life-years gained (LYG) and quality-adjustedlife-years (QALY) gained, and 3% and 0% annual discounting is done. The results are presented as different WTPthresholds (incremental and aggregate cost-effectiveness ratios, and incremental investments, II). Heterogeneity is handledusing conditional (Hurdle) modeling. Results: In 1,092 decisions, the mean discounted (undiscounted) incrementalWTP/QALY gained is € 102,616 (€ 78,686) and € 94,770 (€ 77,856) measured with 15D and EQ-5D, respectively. Themean discounted (undiscounted) incremental WTP/LYG is € 66,277 (€ 58,160). The highest incremental WTPs arereported for cancer (€ 205,994–250,509/QALY gained) and lowest for metabolic disease (€ 23,492–43,398/QALY gained)treatment. The discounted (undiscounted) IIs to health care are € 83,886 (€ 85,398) Euros; metabolic presenting the highest(€ 199,499-213,808) and coronary heart disease treatment (€ 36,124-36,736) the lowest value for the lifetime of the patient.WTP is dependent upon disease/treatment, patient's age, time preference, health benefit type and discounting. Minordifferences between clinicians and politicians are observed. Conclusion: WTP vary for different diseases and is notexplained by incremental costs. Thus, a single WTP for all treatments/diseases hypothesis do not gain empirical support -WTP is better explained by treatment and patient/disease characteristics. Cost-effectiveness and II have a trade-off, whichencourages studies including both efficiency and affordability.
机译：目的：从终身角度评估八种新疗法的支付意愿（WTP）。方法：将带有虚拟实例和二选题的偶然评估分发给芬兰诊所（N 146）和政客（N 73）。成本和公用事业费用（15D，EQ-5D）来自芬兰，假定医疗保健付款人的观点。使用获得的生命年（LYG）和获得质量调整的生命年（QALY）来衡量健康收益，并进行了3％和0％的年度折现。结果以不同的WTP阈值表示（增量和总成本效益比，以及增量投资，II）。异质性使用条件（障碍）建模来处理。结果：在1,092个决策中，使用15D和EQ-5D测得的平均WTP / QALY贴现（未折现）增量为102,616欧元（78,686欧元）和94,770欧元（77,856欧元）。折扣后的Themean贴现（未折现）WTP / LYG为66,277欧元（58,160欧元）。据报道，癌症治疗的WTP增量最高（获得205,994–250,509 / QALY），代谢疾病治疗的最低WTP（获得23,492–43,398 / QALY）最低。贴现（未折现）的卫生保健费用为83,886欧元（85,398欧元）;在患者的一生中，代谢最高（199,499-213,808欧元），冠心病（36,124-36,736欧元）最低。WTP取决于疾病/治疗，患者的年龄，时间偏好，健康福利类型和折扣。观察到临床医生和政治家之间的细微差别。结论：WTP因疾病而异，无法通过增加的费用来解释。因此，所有治疗/疾病假说的单一WTP无法获得经验支持-通过治疗和患者/疾病特征可以更好地解释WTP。成本效益和II需要权衡取舍，这鼓励了包括效率和负担能力的研究。

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