医療技術評価 HTA Health Technology Assessment ?· 医療技術評価(HTA:H ea l thT c nogy…

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  • 54 20128Copyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    HTAHealth Technology Assessment

    CONTENTS HTAHTAHTA

    1 HTAHealthTechnologyAssess-mentHTA

    2 HTAHTA2014HTA

    3 HTA

    4

    5 HTA

  • 55HTAHealth Technology AssessmentCopyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    HTA

    HTAHealth Technology AssessmentHTAEBMEvidence-based Medicine

    1992

    2010201112HTAHTA1

    1HTAHealth Technology Assessment

    HTA

    EBMHTA

    EBM

    3HTA

    HTA

    EBMEvidence-based MedicineOECDOECD

    2011

    HTA

  • 56 20128Copyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    1HTA

    19928

    200712

    201011

    2010 HTA

    2011 5

    2012 4 20144

    20125231

    2OECDHTA

    Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No Yes n.a. No Yes Yes Yes n.a. Yes Yes Yes n.a. Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes n.a. Yes Yes Yes Yes Yes Yes No Yes Yes

    22 17 11 15 6 10 14 7 11

    OECDOECD2011

  • 57HTAHealth Technology AssessmentCopyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    HTA

    HTA2011

    HTA

    NICENational Institute for Health and Clinical ExcellenceNICE2014VBPValue-based PricingHTA2

    HTA

    2OECDHTA

    Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No Yes n.a. No Yes Yes Yes n.a. Yes Yes Yes n.a. Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes n.a. Yes Yes Yes Yes Yes Yes No Yes Yes

    22 17 11 15 6 10 14 7 11

    OECDOECD2011

  • 58 20128Copyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    HTAHTA

    HTAHTA

    HTA

    1 HTA

    3

    1

    CMACost-minimi-zation analysis

    CEACost-effectiveness analysis

    CUACost-utility analy-sis QALYQuality-adjusted life yearQALYQOLQuality of Life

    2HTA

    HTA

    2003

  • 59HTAHealth Technology AssessmentCopyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    QOLQOLQOL

    CBACost-benefi t ana-lysis

    2

    3

    Pharmacoeconomics

    CMA CEA CUA CBA

    1

    2

    4

    3

    2003

    4

  • 60 20128Copyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    3

    2008

    4

    QOLQALY

    2

    5

    A

    CD

    E

    CD

    E

    F

    B

    B

  • 61HTAHealth Technology AssessmentCopyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    QOL

    6

  • 62 20128Copyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    1

    7

    GoNoGo

    MR

    MRWTP

    MRMedical RepresentativeWTP

  • 63HTAHealth Technology AssessmentCopyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    2

    HTA

    MRMedical Representative

    WTP

    3

    1 1

    OTC

    OTC

    OTC

    1

    1

  • 64 20128Copyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    Willingness to pay

    50

    300

    HTAHTA

    HTAHTA

    1 161 2011

    2 HTA

    Vol.21 2 HTA2011

    HTAVol.213HTA2011

    3 Web http://www.pharm.or.jp/

    9

    0

    20

    40

    60

    80

    100

    0 100 200 300 500 700 1,000 1,500 2,000 2,500 5,000

    %

    300

    8

  • 65HTAHealth Technology AssessmentCopyright2012 Nomura Research Institute, Ltd. All rights reserved. No reproduction or republication without written permission.

    1 OECDOECDOECD2011

    2 1PMDRSVol.43 No.12012

    3 2EBM, VBM, HTAPMDRSVol.43 No.42012

    4

    20055

    2003

    HTA HTA HTA1 1 2 3 4

    2

    1 2