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Tác động của Rối loạn Tăng động Giảm chú ý (ADHD) đối với chi tiêu thuốc kê đơn cho trẻ em và thanh thiếu niên: sự gia tăng tầm quan trọng của chứng cứ kinh tế sức khỏe
Tóm tắt
Trong thập kỷ qua, chi tiêu cho dược phẩm cho bệnh nhân mắc Rối loạn Tăng động Giảm chú ý (ADHD) đã gia tăng trên toàn cầu. Đầu tiên, nghiên cứu nhằm ước lượng các xu hướng tương lai của chi tiêu thuốc liên quan đến ADHD từ góc độ của bảo hiểm y tế bắt buộc (SHI; Gesetzliche Krankenversicherung, GKV) ở Đức và Dịch vụ Y tế Quốc gia (NHS) ở Anh, cho trẻ em và thanh thiếu niên từ 6 đến 18 tuổi. Thứ hai, đánh giá tác động ngân sách đối với các nhà kê đơn cá nhân (bác sĩ tâm thần nhi và bác sĩ nhi khoa điều trị bệnh nhân mắc ADHD) tại Đức. Một mô hình đã được phát triển để dự đoán các kịch bản khả thi về chi tiêu dược phẩm trong điều trị ADHD. Các dữ liệu đầu vào của mô hình được lấy từ thông tin nhân khẩu học và dịch tễ học, tổng quan tài liệu về xu hướng chi tiêu trong quá khứ, và phân tích các sản phẩm dược phẩm mới đang trong quá trình phát triển cho ADHD. Chỉ những sản phẩm ở giai đoạn phát triển lâm sàng giai đoạn III trở lên mới được xem xét. Sự không chắc chắn đã được giải quyết thông qua phân tích kịch bản. Đối với mỗi khu vực pháp lý, năm kịch bản sử dụng các giả định khác nhau về tỷ lệ chẩn đoán trong tương lai, tỷ lệ điều trị, tỷ lệ chấp nhận và chi phí đơn vị của các loại thuốc mới cũng như cường độ điều trị. Chi tiêu cho dược phẩm ADHD hàng năm cho trẻ em và thanh thiếu niên sẽ tiếp tục gia tăng và có thể vượt quá 310 triệu EUR (D; E: 78 triệu ₤) vào năm 2012 (2002: ~21,8 triệu EUR; ~7,0 triệu ₤). Trong thời gian này, tổng chi tiêu thuốc của các bác sĩ sẽ có thể tăng từ 2,3 đến 9,5 lần, được tạo ra từ những tác động nhân lên của bốn biến số: số lượng trường hợp được chẩn đoán tăng lên, ngày càng chấp nhận và cường độ điều trị bằng thuốc, cùng với chi phí đơn vị cao hơn của các loại thuốc mới. Ngay cả trong một kịch bản tối thiểu cực đoan, một sự gia tăng chi tiêu cho dược phẩm hơn sáu lần cho trẻ em và thanh thiếu niên được dự đoán trong suốt thập kỷ từ 2002 đến 2012, từ góc nhìn của cả NHS ở Anh và GKV ở Đức. Dự đoán tác động ngân sách này chỉ đại diện cho một phân tích phần nào đó vì các chi tiêu khác cũng rất có khả năng sẽ gia tăng, chẳng hạn như những liên quan đến dịch vụ của bác sĩ, bao gồm chẩn đoán và điều trị tâm lý xã hội. Hơn nữa, theo định nghĩa, các phân tích tác động ngân sách hầu như không đưa ra bất kỳ điều gì về sự phù hợp lâm sàng và giá trị của tiền. Những nhà cung cấp dịch vụ chăm sóc cho trẻ em và thanh thiếu niên mắc ADHD cần chuẩn bị đối mặt với những thách thức nghiêm trọng liên quan đến hiệu quả chi phí của các can thiệp.
Từ khóa
#Rối loạn Tăng động Giảm chú ý #chi tiêu dược phẩm #trẻ em #thanh thiếu niên #kinh tế sức khỏeTài liệu tham khảo
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