支持医保知证决策的肺癌新药多维价值评估框架

Multidimensional value assessment framework for new anti-lung cancer drugs to support evidence-informed medical insurance decision-making

摘要

目的: 构建肺癌新药的多维价值评估框架,以支持医保报销的知证决策。方法: 检索并获取评估肺癌新药价值的相关文献,通过文献分析和专题小组讨论初步构建框架。采用德尔菲法确定准则、子准则及权重以及价值评估方法。通过3种肺癌新药的价值评估验证框架的可行性。结果: 构建的肺癌新药多维价值评估框架由5个核心准则、2个情境化准则以及20个子准则组成。核心准则包含相对有效性、相对安全性、可负担性、经济性和证据质量,其中相对有效性具有最高的权重。在核心准则的子准则中,总生存期和无进展生存期具有最高的权重。情境化准则包括创新性和公平性。结论: 结构化的多维价值评估框架为医保决策者提供了决策支持工具,有助于提升决策的科学性和透明度。

Abstract

Objective: To construct a multidimensional value assessment framework for novel drugs for lung cancer, thereby supporting evidence-informed decision-making for medical insurance reimbursement. Methods: First, literature on the value assessment of novel drugs for lung cancer was searched and reviewed. Based on a literature review and a focus group discussion, the framework was preliminarily constructed. Then, the Delphi method was used to determine the criteria, sub-criteria, weights, and value assessment methods. Finally, the feasibility of framework was verified through the value assessment of three novel drugs for lung cancer. Results: The constructed multidimensional value assessment framework for novel drugs for lung cancer consists of five core criteria, two contextualized criteria, and 20 sub-criteria. The core criteria include comparative effectiveness, comparative safety, affordability, economic value, and evidence quality, with comparative effectiveness having the highest weight. Among the sub-criteria of the core criteria, overall survival and progression-free survival have the highest weights. The contextual criteria are innovation and equity. Conclusion: The structured multidimensional value assessment framework provides a decision-support tool for medical insurance policymakers and helps to improve the scientific rigor and transparency of decision-making.

关键词

肺癌新药 / 医保 / 知证决策 / 价值评估框架 / 多准则决策分析

Key words

new anti-lung cancer drugs / medical insurance / evidence-informed decision-making / value assessment framework / multi-criteria decision analysis

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基金资助

国家自然科学基金面上资助项目(72374113)