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支持医保知证决策的降糖新药多维价值评估框架研究
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| 篇名： | 支持医保知证决策的降糖新药多维价值评估框架研究 |
| TITLE： | Research on the multi-dimensional value assessment framework for new antidiabetic drugs to support evidence-informed medical insurance decision-making |
| 摘要： | 目的 基于多准则决策分析理论构建降糖新药的多维价值评估框架，为医保知证决策提供理论框架和方法学借鉴。方法首先，通过系统检索和获取多维度证据，为框架建立提供数据支持。其次，基于获取的证据，采用内部专题小组讨论的方式，初步构建价值评估框架，确定框架的结构、核心准则以及情境化准则。最后，通过专家咨询进一步确定框架的准则和子准则及其权重，明确子准则的纳入依据和参考评分的合理性并优化评估方法。结果降糖新药多维价值评估框架由核心准则和情境化准则组成，分别用于新药价值的量化评估和定性评价。核心准则由5个维度组成，重要性由高到低依次是可负担性（6.31）、相对有效性（6.20）、相对安全性（6.01）、经济性（5.89）和证据质量（5.46）；子准则权重被归一化校正后，医保预算影响成为了具有最高标化权重的子准则，其次是糖化血红蛋白的控制和患者的可负担性。情境化准则包括2个维度，即创新性和公平性。结论所建评估框架整合了证据、利益相关方的价值诉求和决策情境，有助于实现降糖新药价值的多维度和循证评估。 |
| ABSTRACT： | OBJECTIVE To establish a multi-dimensional value assessment framework for new antidiabetic drugs based on multi-criteria decision analysis theory， thus providing a theoretical framework and methodology for evidence-informed medical insurance decision-making. METHODS Firstly， multi-dimensional evidence was searched and obtained to provide reliable data for the establishment of the framework. Secondly， in terms of the obtained evidence， the value assessment framework was preliminarily constructed. Its structure， main core criteria， and contextual criteria were determined through focus group discussion. Finally， the criteria and sub-criteria of the framework and their weights were further determined， reasons for inclusion of sub-criteria and the reasonableness of rating scores were evaluated， and methods of assessment were optimized through expert consultation. RESULTS The multi-dimensional value assessment framework for new antidiabetic drugs was composed of core criteria and contextualized criteria， which could be used for quantitative and qualitative value assessment of new drugs， respectively. The core criteria consisted of five dimensions， with affordability （6.31） having the highest weighting score， followed by comparative effectiveness （6.20）， comparative safety （6.01）， cost-effectiveness （5.89）， and quality of evidence （5.46）. After the normalization of weight within sub-criteria， the budget impact on medical insurance had the highest standardized weight， followed by the control of glycated hemoglobin and patient affordability. The contextual criteria included two dimensions， i. e.， innovation and equity. CONCLUSIONS The assessment framework integrates evidence， stakeholders’ values， and decision contexts to enable a multi- dimensional and evidence-based assessment of the value of new antidiabetic drugs. |
| 期刊： | 2025年第36卷第13期 |
| 作者： | 颜菲菲；陈靖宇；陈家然；潘晨；王国华；耿劲松 |
| AUTHORS： | YAN Feifei，CHEN Jingyu，CHEN Jiaran，PAN Chen，WANG Guohua，GENG Jinsong |
| 关键字： | 降糖新药；知证决策；医保；价值评估框架；多准则决策分析 |
| KEYWORDS： | new antidiabetic drugs； evidence-informed decision-making； medical insurance； value assessment framework； |
| 阅读数： | 1 次 |
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