[ASCO-GI 2015]10万美元多购买六个星期无进展生存值得吗?——David J. Kerr博士访谈
编者按:2015胃肠癌症研讨会1月17日的日程中,David J. Kerr博士代表英国国家临床规范研究院做了“结直肠癌指南制定”演讲。讲座结束后,《肿瘤瞭望》的前方记者就高额医疗费用的问题采访他。
60000 mark because when we look across the spectrum of healthcare (the benefits scheme from hip replacements for example or the benefit schemes from any aspect of medicine) that seems about the right price to pay. We are looking across all fields of medicine and not just cancer. Different societies or different democracies would set the level differently.
Kerr博士:英国的医保承担范围是50000 ~60000美元,这个区间似乎很合理。不同国家或地区有其自己的医保标准。卡塔尔最富有,医保计划覆盖了所有医疗项目。
Oncology Frontier: In your talk you compared value to not going into the supermarket and browsing the scratch-and-dent shelf. Can you expand on that analogy?
《肿瘤瞭望》:您衡量医疗的“价值”不是根据市场规律,还是根据国家的财政情况,请您再详细地阐述这个问题。
Dr Kerr: I have a very clear definition of value and when I say it I see people recoil, because they associate value with pure quality. They associate it with fine cuts of meat at the value end of the supermarket and it is just a constant reminder to be aware of the structure of language when we try to explain moderately complicated ideas. I think value is simple. But for different people, value means different things.
Kerr博士:我对“价值”的定义清晰且简单,但是每个人都有自己的价值定义,他们认为价值与品质相关,他们把价值理解为日常购物,是否“物有所值” ,显示了语言解释复杂问题的有限性。
Dr Kerr: Michael Porter at Harvard has done it for us. He is a fantastic, thoughtful health systems guru. His definition of value works very well for me. Usually value is based on volume rather than outcomes which would mean the volumes of patients treated and the money associated with that. What he has done has adapted the system in which we look at the cost of all the various treatments that we introduce but we relate them to hard outcomes. That is the key to it. By doing that you encompass both efficiency and cost.
Kerr博士:哈佛大学的迈克尔·波特是一个很优秀的卫生系统专家。他对价值定义很好地表达了我的意思。价值是基于治疗患者的“量”,而不是治疗效果,关键是要同时考虑到效率和虑成本。