贝叶斯混合处理比较法在药物经济学评价中的应用
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篇名: 贝叶斯混合处理比较法在药物经济学评价中的应用
TITLE:
摘要: 目的:探究贝叶斯混合处理比较(MTC)法的基本原理、优势及其应用前景,为拓宽药物经济学的研究思路提供理论支持。方法:采用文献研究的方法,以我国药物经济学研究已应用的决策分析模型中存在的问题为出发点,对MTC法在国内外各领域的发展与应用进行梳理,研究其在我国的应用与发展前景。结果与结论:药物经济学的评价方法对基本药物和医疗保险目录药物以及基本医疗和基本公共卫生项目的遴选起到至关重要的作用,其评价结果直接影响到医药资源配置的总效率。目前,我国药物经济学评价中常用的决策分析模型并不能有效解决药物经济学评价中存在的问题,表现在:决策树模型难以对长期治疗方案作出评价;马尔可夫模型和多属性效用理论的使用受到模型参数限制;离散事件模拟有赖于完善的流行病学研究和临床试验而使模型应用受限。MTC法是近年来在药物经济学评价中新兴的一种方法,是传统Meta分析方法的扩展,可以同时对多个不同临床处理因素的直接或间接证据进行整合,并相互分析、比较,以便在缺少证据支持的情况下仍能对各种干预措施作出综合评估,较好地弥补了当前药物经济学评价的局限性。
ABSTRACT: OBJECTIVE: To explore the basic principles, advantages and application prospects of Bayesian mixed treatment comparison (MTC), and provide theoretic support for making reasonable decisions of pharmacoeconomics. METHODS: The problems existing in model and method that had been used in the study of pharmacoeconomics as starting point, literature research was used to sort out the domestic development and applications of MTC and study its application and development prospect. RESULTS & CONCLUSIONS: The evaluation methods of pharmacoeconomics play an important role in selection of essential medicines, medicare insurance directory medicines, basic health and basic public health programs, the results directly affect the total effective rate of medical resources’ configuration. The current research models cannot effectively solve the problem, for example, decision tree model is difficult to make evaluation of long-term treatment; Markov model and the use of multiple attribute utility theory are restricted by the model parameters; discrete event simulation is limited because it depends on the epidemiological study and clinical trial. MTC, an extension approach of the traditional Meta-analysis, is an effective new method developed recently to analyze and compare the direct or indirect evidence of several different clinical treatment factors in order to make a comprehensive evaluation of the various interventions in the absence of evidence support. So the MTC can make up for the limitation of current evaluation methods.
期刊: 2016年第27卷第23期
作者: 师宇,饶惠霞,翁开源
AUTHORS: SHI Yu,RAO Huixia,WENG Kaiyuan
关键字: 贝叶斯混合处理比较法;药物经济学评价;应用
KEYWORDS: Bayesian mixed treatment comparison method; Pharmacoeconomics evaluation; Application
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