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KMID : 1170320210270040131
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Korean Journal of Health Economics and Policy
2021 Volume.27 No. 4 p.131 ~ p.152
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Uncertainties in cost-effectiveness analysis
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Bae Eun-Young
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Abstract
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There are many uncertainties on cost-effectiveness among high-priced new drugs that have recently entered the market. Considering the social concerns about these drugs and the financial burden of national health insurance, evaluating and managing the uncertainty is expected to become a significant policy concern in the future. Uncertainties surrounding incremental cost-effectiveness ratio are divided into stochastic, structural, and parametric uncertainties and heterogeneity. Among them, parametric uncertainty is mainly evaluated through sensitivity analysis, and efforts are being made to evaluate the value of securing additional evidence through the value of information analysis. Structural uncertainty is overlooked compared to parametric uncertainty despite its significant impact on the results.
Scenario analysis, model selection, model averaging, and parameterization have been proposed to analyze it. The performance-based risk-sharing scheme, particularly coverage with evidence development, has been proposed as a risk management plan. However, suppose the data collection plan is not based on uncertainty assessment and is not liked to the decision-making stage. In that case, additional data may have little impact on the final decisions.
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KEYWORD
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cost-effectiveness analysis, uncertainty, value of information, risk sharing
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FullTexts / Linksout information
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