卫生技术定价和付款计划的设计与特点:医疗技术定价与支付方案的设计与特点:范围审查与灵活的需求驱动分类建议》。

IF 4.4 3区 医学 Q1 ECONOMICS PharmacoEconomics Pub Date : 2024-10-15 DOI:10.1007/s40273-024-01435-2
Vittoria Ardito, Oriana Ciani, Michael Drummond
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引用次数: 0

摘要

背景和目的:在临床和财务不确定性日益增加的情况下,定价和付款计划可以作为解决医疗技术的可负担性和可及性问题的可行方案。然而,目前还缺乏对现有方案的全面分类,以帮助决策者应对这些挑战。这项工作旨在绘制现有定价和付款计划的类型图,并提出一种新的分类方法,以帮助决策者和其他利益相关者选择最符合其需求的计划类型:方法:2010 年至 2023 年期间,在三个数据库(PubMed、Web of Science 和 Scopus)中进行了符合范围界定文献综述(PRISMA-ScR)标准的范围界定文献综述。搜索策略围绕 "定价/支付方案 "和 "方案创新性 "两组关键词展开。符合条件的研究说明了每种方案类型的独特设计和特点,这些研究由两名独立审稿人进行提取,并采用叙述格式进行综合,包括每种方案类型的详细表格说明:结果:共确定了 70 种独特的定价和付款方案。其中约三分之一(33%)只是原则性规定,三分之二(67%)已在实践中实施。约有一半的计划类型是针对药物提出的(34/70,49%),绝大多数计划类型不是针对特定治疗领域设计的(55/70,79%)。每种计划类型都根据不同的特点进行了分类:目标、结果部分、支付时间/方式以及证据收集要求:我们没有试图将检索到的计划纳入一个僵化的分类法,而是提出了一种新的方法,建议根据需要灵活使用现有的计划类型,主要由一个计划可能具有的特定目标驱动,并允许利用每类计划的其他关键特征。
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Design and Features of Pricing and Payment Schemes for Health Technologies: A Scoping Review and a Proposal for a Flexible Need-Driven Classification.

Background and objective: In a context of growing clinical and financial uncertainty, pricing and payment schemes can act as possible solutions to the problems of affordability and access to health technologies. However, a comprehensive categorization of the available schemes to help decision makers tackle these challenges is lacking. This work aims at mapping existing types of pricing and payment schemes, and proposes a new approach for their classification, in order to help decision makers and other stakeholders select the best type of scheme to meet their needs.

Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR)-compliant scoping literature review was performed between 2010 and 2023 in three databases (PubMed, Web of Science, Scopus). The search strategy was developed around two groups of keywords, "pricing/payment schemes" and "scheme innovativeness". Eligible studies were those illustrating the unique design and features of each scheme type, which were extracted by two independent reviewers, and synthesized using a narrative format, including a detailed tabular description of each type of scheme.

Results: A total of 70 unique types of pricing and payment schemes were identified. Around one third (33%) was only specified in principle, while two thirds (67%) had been implemented in practice. About half of the scheme types were proposed for drugs (34/70, 49%), and the vast majority were not designed for a specific therapeutic area (55/70, 79%). Each scheme type was categorized based on distinctive characteristics: the objectives, the outcome component, the timing/modalities of payments, and the evidence collection requirements.

Conclusions: Instead of trying to fit the retrieved schemes into a rigid taxonomy, we propose a new approach that suggests a flexible need-driven use of the available scheme types, driven primarily by the specific objective that one might have, and allows leveraging of the other key characteristics of each type of scheme.

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来源期刊
PharmacoEconomics
PharmacoEconomics 医学-药学
CiteScore
8.10
自引率
9.10%
发文量
85
审稿时长
6-12 weeks
期刊介绍: PharmacoEconomics is the benchmark journal for peer-reviewed, authoritative and practical articles on the application of pharmacoeconomics and quality-of-life assessment to optimum drug therapy and health outcomes. An invaluable source of applied pharmacoeconomic original research and educational material for the healthcare decision maker. PharmacoEconomics is dedicated to the clear communication of complex pharmacoeconomic issues related to patient care and drug utilization. PharmacoEconomics offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by a Key Points summary, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article.
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