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国际药物经济学评价指南中贴现率设定与调整
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| 篇名： | 国际药物经济学评价指南中贴现率设定与调整 |
| TITLE： | Discount rate setting and adjustment in international pharmacoeconomic evaluation guidelines |
| 摘要： | 目的 为我国药物经济学评价指南贴现率的调整提供方向及参考。方法检索国际药物经济学与结果研究协会、各国/地区卫生技术评估机构官方网站及其他中高收入、高收入国家/地区的相关网站，汇总并比较各国/地区药物经济学评价指南中贴现率的推荐情况、调整趋势及设定依据。基于理论推导和文献分析，讨论不同贴现率取值对增量成本-效果比（ICER）的影响。结果与结论在纳入的40个国家/地区药物经济学评价指南中，基础分析贴现率的取值范围为1.5%～5%，5%为最常用值；敏感性分析的取值范围为0～12%。36个国家/地区对基础分析的成本和健康产出采用相同的贴现率，而荷兰、比利时、波兰、捷克的成本贴现率高于健康产出贴现率。近年来，韩国、法国、爱尔兰根据经济环境变化下调了贴现率，而荷兰和捷克则上调了成本贴现率。贴现率的设定主要依据公共项目投资利率或参考国际权威机构建议及其他相关指南。不同贴现率取值对ICER的影响方向及幅度主要取决于干预措施与对照措施的成本和健康产出分布情况。贴现率的设定与调整与经济环境密切相关。我国可借鉴国际经验将贴现率下调0.5%～1.5%，同时参考国际常用的贴现率估算方法开展本土实证研究。 |
| ABSTRACT： | OBJECTIVE To provide direction and reference for the adjustment of the discount rate （DR） in China’s pharmacoeconomic guidelines. METHODS Search was conducted on the official websites of the International Society for Pharmacoeconomics and Outcomes Research， health technology assessment agencies in various countries/regions， as well as relevant websites of other upper-middle-income or high-income countries/regions. The recommended DR， adjustment trends， and setting rationales in pharmacoeconomic evaluation guidelines across different countries/regions were then summarized and compared. Based on theoretical derivation and literature analysis， the effects of different DR on the incremental cost-effectiveness ratio （ICER） were examined. RESULTS & CONCLUSIONS Among the 40 included guidelines， the base-case DR ranged from 1.5% to 5%， with 5% being the most common value； the range for sensitivity analysis was 0 to 12%. Thirty-six countries/regions applied the same DR to both costs and health outcomes， while in the Netherlands， Belgium， Poland and Czech Republic， DR for costs was higher than for health outcomes. In recent years， Korea， France and Ireland had lowered their DR in response to economic changes， whereas the Netherlands and Czech Republic had raised their DR for cost. The setting of the DR was primarily based on the public project investment interest rate or referred to recommendations from internationally authoritative institutions and other relevant guidelines. The direction and magnitude of the impact of different DR on the ICER largely depended on the distribution of costs and health outcomes between the intervention and reference measure. The setting and adjustment of DR were closely associated with the economic environment. Based on international experience, the DR in China can be lowered by 0.5% to 1.5%， and localized empirical research can be conducted using internationally common estimation methods. |
| 期刊： | 2025年第36卷第20期 |
| 作者： | 李艺伟；张璟博；杨惠雯；王翰飞；索于思；王涵；顾知恩；金雪晶 |
| AUTHORS： | LI Yiwei，ZHANG Jingbo，YANG Huiwen，WANG Hanfei，SUO Yusi，WANG Han，GU Zhien，JIN Xuejing |
| 关键字： | 药物经济学评价；指南；贴现率；增量成本-效果比 |
| KEYWORDS： | pharmacoeconomic evaluation； guidelines； |
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