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【drug-news】生命价值多少? 且看药品费用
By Ed Silverman // December 3rd, 2008 // 8:48 am
When Bruce Hardy’s kidney cancer spread to his lung, his doctor recommended an expensive new pill from Pfizer. But Hardy is British, and UK health authorities refused to buy the drug. If the Hardys lived in the US or another European country, he would most likely get the drug, although he might have to pay part of the cost, The New York Times writes about the UK controversy over paying for meds.
A clinical trial showed the Pfizer pill, called Sutent, delays cancer progression for six months at an estimated treatment cost of $54,000. But at that price, Hardy’s life is not worth prolonging, according to the UK’s National Institute for Health and Clinical Excellence, which has decided that, except in rare cases, the government can only afford about $22,750 to save six months of a citizen’s life.
After substantial protest, UK authorities are reconsidering decisions on various drugs, after years of being almost alone in using evidence of cost-effectiveness (back story). But skyrocketing prices have led more countries to ask the hardest of questions: How much is life worth? For many, NICE has the answer. Top health officials in Austria, Brazil, Columbia and Thailand say NICE strongly influences their policies (click on the chart to enlarge).
“All the middle-income countries - in Eastern Europe, Central and South America, the Middle East and all over Asia - are aware of NICE and are thinking about setting up something similar,” Andreas Seiter, a senior health specialist at the World Bank, tells the Times.
In the US, rising costs have led some in Congress to propose an institute that would compare the effectiveness of new medical technologies, although the proposals so far would not allow for price considerations. At the present rate of growth, medical costs will increase to 25 percent of the nation’s gross domestic product in 2025 from 16 percent, with half of the increase coming from new drugs and devices, according to the Congressional Budget Office, the Times writes.
To arrest this trend, the US needs to adopt at least some of NICE’s methods, according to Mark McClellan and Sean Tunis, who served in the Bush administration as, respectively, administrator and chief medical officer of the Center for Medicare and Medicaid Services. Tunis says he spent a lot of time in government “learning about NICE and trying to adopt the processes and mechanisms they used, and we just couldn’t.” Why? Using price to determine Medicare or Medicaid payments provoked fierce protests. But McClellan says the US will soon have no choice. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 欢迎战友指正～
How Much Is A Life Worth? The Cost Of A Drug
生命价值多少? 且看药品费用
By Ed Silverman // December 3rd, 2008 // 8:48 am
When Bruce Hardy’s kidney cancer spread to his lung, his doctor recommended an expensive new pill from Pfizer. But Hardy is British, and UK health authorities refused to buy the drug. If the Hardys lived in the US or another European country, he would most likely get the drug, although he might have to pay part of the cost, The New York Times writes about the UK controversy over paying for meds.
当癌细胞从布鲁斯.哈迪（Bruce Hardy ）的肾扩散到肺部时，医生建议他使用辉瑞公司价格昂贵的一种新药。但是哈迪是英国人，而英国的卫生管理局拒绝支付该药品。关于英国医药费支付方面的争议，纽约时报（New York Times）报道称，如果哈迪居住在美国或其他欧洲国家，极有可能应用该药，虽然有可能需要个人支付部分费用。
A clinical trial showed the Pfizer pill, called Sutent, delays cancer progression for six months at an estimated treatment cost of $54,000. But at that price, Hardy’s life is not worth prolonging, according to the UK’s National Institute for Health and Clinical Excellence, which has decided that, except in rare cases, the government can only afford about $22,750 to save six months of a citizen’s life.
临床试验证实辉瑞的新药Sutent（舒尼替尼）可以使癌细胞扩散延缓六个月，治疗费估计约为5.4万美元。但是根据英国国立临床规范研究所（NICE）的规定，除非罕见病例，政府对于延长六个月生命期的治疗，支付限度约为22,750 美元，所以并不值得以5.4万美元来延长哈迪的生命。
After substantial protest, UK authorities are reconsidering decisions on various drugs, after years of being almost alone in using evidence of cost-effectiveness (back story). But skyrocketing prices have led more countries to ask the hardest of questions: How much is life worth? For many, NICE has the answer. Top health officials in Austria, Brazil, Columbia and Thailand say NICE strongly influences their policies (click on the chart to enlarge).
英国卫生当局多年以来几乎一直单纯以成本效益来评价药品，目前这种做法受到强烈抗议，英国当局正在重新考虑这些决议。但是持续高涨的药价使越来越多的国家开始考虑这个最严峻的问题：生命的价值有多大？对很多国家来说，NICE给出了答案。奥地利、巴西、哥伦比亚和泰国的医疗卫生管理局都承认受到NICE的强烈影响。
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作者:admin@医学,生命科学 2011-04-07 17:18
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