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·药物经济学·
癌症患者健康效用测量方法介绍
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刘 博 ,徐 娟 ,Georg Kemmler ,李浩飞 ,常恩雪 ,郑万基 ,谷 文 ,周 澜 ,刘 瑞 ,黄卫东 ,罗 南 3
(1.哈尔滨医科大学卫生管理学院,哈尔滨 150081;2.因斯布鲁克医科大学精神病学和心理治疗系,奥地利 因
斯布鲁克 6020;3.新加坡国立大学苏瑞福公共卫生学院,新加坡 117549)
中图分类号 R956 文献标志码 A 文章编号 1001-0408(2023)04-0450-07
DOI 10.6039/j.issn.1001-0408.2023.04.13
摘 要 癌症作为严重威胁人类健康的主要致死疾病之一,其负担之重亟待缓解,而卫生技术评估可为癌症的诊治防护及相关政
策制定提供科学循证依据。成本-效用分析是卫生技术评估中经济学评价的金标准,而健康效用能否准确测量是决定其结果准确
程度的关键要素之一。本文重点对癌症领域健康效用测量中的直接测量法、多属性健康效用测量量表法和映射法进行系统介绍
并对其在癌症患者中的应用进行评述。其中,直接测量方法在癌症患者测量中存在操作复杂、成本较高以及对受试者的认知要求
较高等不足;多属性健康效用测量量表法是当前癌症患者健康效用测量的首选方法;而映射法随着多属性健康效用测量量表中疾
病特异性效用量表的不断发展完善,在未来应用中可能会逐渐减少。本文可为癌症领域卫生技术评估健康效用测量工具的选择
提供参考,为优化癌症领域资源配置以及政策制定提供循证依据。
关键词 癌症;健康效用;测量方法;卫生技术评估;成本-效用分析
Introduction of measurement methods of health utility for cancer patients
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LIU Bo ,XU Juan , Georg Kemmler ,LI Haofei ,CHANG Enxue ,ZHENG Wanji ,GU Wen ,ZHOU Lan ,LIU
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Rui ,HUANG Weidong ,LUO Nan(1. School of Health Management, Harbin Medical University, Harbin
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150081, China;2. Dept. for Psychiatry and Psychotherapy, Medical University of Innsbruck, Austria Innsbruck
6020, Austria;3. Saw Swee Hock School of Public Health, National University of Singapore, Singapore
117549, Singapore)
ABSTRACT Cancer is one of the major fatal diseases that seriously threaten human health, and its burden needs to be solved
urgently. Health technology assessment (HTA) can provide scientific evidence-based basis for cancer diagnosis, treatment,
prevention and related policy formulation. Cost-utility analysis is the gold standard for economic evaluation in HTA, and the
accurate measurement of its health utility is one of the key elements to determine the accuracy of its results. This article focuses on
systematic introduction of direct measures, multi-attribute health utility scales, and mapping methods in the field of cancer
measurement and reviews their applications in cancer patients. Among them, direct measures are complex, costly, and require a
high level of subject knowledge; multi-attribute health utility measures are currently the preferred method for measuring health
utility in cancer patients; with the continuous development and refinement of disease-specific utility measures in multi-attribute
health utility instruments, the mapping method may gradually decrease in future applications. This paper can provide a reference for
the selection of health utility measurement tools for HTA in the field of cancer, and provide evidence-based basis for optimizing
resource allocation and policy formulation in the field of cancer.
KEYWORDS cancer; health utility; measurement method; health technology assessment; cost-utility analysis
癌症作为严重威胁人类健康的主要致死疾病之一, 之重亟待破解 。成本-效用分析(cost-utility analysis,
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近年来新发癌症病例数和死亡病例数不断上升,其负担 CUA)作为卫生技术评估(health technology assessment,
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HTA)常用的研究方法 ,可用于比较不同癌症领域的干
Δ 基金项目 国家自然科学基金资助项目(No.71974048);美国中
华医学基金会公开竞争项目(No.CMB-19-308) 预措施,为癌症的诊治、防护及相关政策制定提供科学
*第一作者 硕士研究生。研究方向:卫生技术评估、健康效用测 循证依据。健康效用(health utility)是人们对某种特定
量与健康结果研究。E-mail:lb980824@163.com
健康状态的偏好程度,用于反映生命质量的权重,其准
# 通信作者 研究员,博士生导师,博士。研究方向:经济学评价、
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健康结果研究、卫生政策、医疗保障。E-mail:weidong218@126.com 确测量是 CUA 结果可靠性的重要保证 。本文对癌症
· 450 · China Pharmacy 2023 Vol. 34 No. 4 中国药房 2023年第34卷第4期