بررسی وضعیت مدیریت مبتنی بر شواهد ارزشیابی اقتصادی در حوزه دارو نظام سلامت ایران و کشورهای منتخب: مطالعه تطبیقی
محورهای موضوعی : -مدیریت خدمات بهداشتی و درمانیابوالفضل علیاری 1 , شقایق وحدت 2 , سعاد محفوظ پور 3 , حسین مشیری تبریزی 4
1 - دانشجوی دکتری مدیریت خدمات بهداشتی درمانی، واحد تهران جنوب، دانشگاه آزاد اسلامی، تهران، ایران
2 - استادیار، مدیریت خدمات بهداشتی درمانی، واحد تهران جنوب، دانشگاه آزاد اسلامی، تهران، ایران
3 - دانشیار، مدیریت خدمات بهداشتی درمانی، واحد تهران جنوب، دانشگاه آزاد اسلامی، تهران، ایران
4 - استادیار، مدیریت خدمات بهداشتی درمانی، واحد تهران جنوب، دانشگاه آزاد اسلامی، تهران، ایران
کلید واژه: مدیریت مبتنی بر شواهد, ارزشیابی اقتصادی, نظام سلامت, دارو,
چکیده مقاله :
مقدمه: امروزه در سطح بین المللی بهره‌گیری از شواهد در تصمیم‌گیری در زمینه سیاست‌گذاری و برنامه‌ریزی بخش سلامت و دارو امری ضروری است. لذا این پژوهش با هدف مقایسه وضعیت مدیریت مبتنی بر شواهدارزشیابی اقتصادی در حوزه دارو درنظام سلامت ایران و کشورهای منتخب انجام گردید. روش پژوهش: این پژوهش، یک مطالعه تطبیقی است که در سال 1401 انجام شد. در این مطالعه، نمونه‌گیری به صورت هدفمند بوده و کشورهای استرالیا، انگلستان، آلمان و کانادا به لحاظ مولفه‌های استفاده از شواهد در ازرشیابی اقتصادی حوزه دارو مورد مقایسه قرارگرفتند. برای گردآوری داده‌ها از پایگاه‌های اطلاعاتی معتبر و سایر منابع مرتبط در زمینه موضوع پژوهش استفاده شد. در این مطالعه، یافته‌های به دست آمده در قالب جدول تطبیقی مورد مقایسه قرارگرفتند. یافته‌ها: یافته‌ها نشان داد که تولید و استخراج شواهد در کشورهای کانادا، انگلستان و استرالیا الزامی و در کشور ایران و آلمان اختیاری است. هم‌چنین نتایج نشان داد که به جزء کشور استرالیا و کانادا در سایر کشورهای دیگر از شواهد برای افزدون داروها به لیست دارویی استفاده نمی‌شود و در همه کشورها نیز به جزء کشور ایران، استانداردها و چارچوب‌های تولید شواهد وجود دارد. نتیجه‌گیری: براساس نتایج پژوهش، طراحی مدل یکپارچه در جهت کاهش موازی کاری، توسعه ارتباطات با پژوهشگران و مراکز تحقیقاتی، تعیین اصول و مقررات تولید و به کارگیری شواهدات، تقویت رهبری، مدیریت و تولیت نظام سلامت متناسب با وضعیت کشور و سایر کشورهای با شرایط مشابه پیشنهاد می‌گردد.
Introduction: Nowadays, at the international level, it is necessary to use evidence in decision-making in the field of policy and planning of the health and medicine sector, the present study was conducted with the aim of investigating the status of management based on economic evaluation evidence in the field of medicine in the health system of Iran and selected countries. Methods: This research is a comparative study that was conducted in 1401. The sampling was purposeful and the countries of Australia, England, Germany and Canada were compared in terms of the components of using evidence in the economic evaluation of the drug field. To collect data, reliable databases and other related sources were used in the field of the research topic. The findings were compared in the form of a comparative table. Results: The findings showed that producing and extracting evidence is mandatory in Canada, England and Australia and optional in Iran and Germany. Also, except for Australia and Canada, in other countries, evidence is not used to add drugs to the drug list. Also, there are standards and frameworks for producing evidence in all countries except Iran. Conclusion: The results showed, designing an integrated model to reduce work parallelism, developing communication with research centers, determining principles and regulations for the production and application of evidence, strengthening the leadership, management and supervision of the health system in accordance with the state of the country and other countries with similar conditions are proposed.
1- Gröne O, Garcia-Barbero M. Integrated care: a position paper of the WHO European office for integrated health care services. International journal of integrated care, 2001;1.
2- Organization WH. Choosing Interventions that are Cost-Effective (WHO-CHOICE). Geneva: World Health Organization; 2012.
3- Yan R. Cost-effective Intervention: Innovative Strategies for Public Health Care: Pennsylvania State University; 2014.
4- Weinstein MC, Skinner JA. Comparative effectiveness and health care spending—implications for reform. New England Journal of Medicine, 2010; 362(5): 460-5.
5- GROL R. Between evidence-based practice and total quality management: the implementation of cost-effective care. International Journal for Quality in Health Care, 2000; 12(4): 297-304.
6- Harrison S. The politics of evidence-based medicine in the United Kingdom. Policy & Politics, 1998; 26(1): 15-31.
7- García Del Junco J, De Reyna Zaballa R, García Álvarez de Perea J. Evidence-based administration for decision making in the framework of knowledge strategic management. The Learning Organization, 2010; 17(4): 343-63.
8- Walshe K, Rundall TG. Evidence-based management: From theory to practice in health care. The Milbank Quarterly, 2001; 79(3): 429-57.
9- Kovner AR, Fine DJ, D'Aquila R. Evidence-based management in healthcare: Health Administration Press; 2009.
10- White KR, Lemak CH, Griffith JR. Improving healthcare management education using principles from Baldrige and evidence-based management. Journal of Health Administration Education, 2011; 28(3): 187-207.
11- Hofmann PBDF. The Ethics of Evidence-Based Management. Healthcare Executive, 2010; 25(1): 48-51.
12- Stewart R. Evidence-based management: a practical guide for health professionals: Radcliffe Publishing; 2002.
13- Hamlin B. In Support of Evidence-Based Healthcare Management: an empirical study of managerial effectiveness within an NHS trust hospital: Management Research Centre, Wolverhampton Business School; 2001.
14- Hewison A. Evidence-based management in the NHS: is it possible? Journal of Health Organization and Management, 2004; 18(5): 336-48.
15- Muir Gray J. Evidence-based healthcare: how to make health policy and management decisions. London: Churchill Livingstone, 1997; 53.
16- Asante AD, Zwi AB. Factors influencing resource allocation decisions and equity in the health system of Ghana. Public Health, 2009; 123(5): 371-7.
17- Manning J. Exceptional circumstances schemes and the social factors exclusion in healthcare rationing. Oxford University Commonwealth Law Journal, 2013; 13(1): 75-114.
18- Samanta A, Samanta J. Evidence-based medicine: A clinical governance tool for rationalising or rationing health care? Clinical Governance: An International Journal, 2005; 10(4): 308-13.
19- Buse K, Mays N, Walt G. Making health policy: McGraw-Hill Education (UK); 2012.
20- Bastani P, Kavosi Z, Poori SA, Nasab MHI. Evidence-based policy and decision-making among health managers: a case of Shiraz University of Medical Sciences. Galen Medical Journal, 2017; 6(1): 30-8.
21- Packer M, Metra M. Guideline‐directed medical therapy for heart failure does not exist: a non‐judgmental framework for describing the level of adherence to evidence‐based drug treatments for patients with a reduced ejection fraction. European Journal of Heart Failure, 2020; 22(10): 1759-67.
22- Imani Nasab MH, Seyedin SH, Majdzadeh SR, Yazdizadeh B, Salehi M. Factors Affecting the Development of Evidence-Based Health Policy Papers at the Ministry of Health Care and Medical Education. Journal of Health Administration, 2015; 18(60): 105-17.
23- Chisholm D, Evans DB. Economic evaluation in health: saving money or improving care? Journal of Medical Economics, 2007; 10(3): 325-37.
24- Chalkidou K, Culyer AJ. Making choices on the journey to universal health care coverage: from advocacy to analysis. Value in Health, 2016; 19(8): 910-2.
25- Hammad EA. The use of economic evidence to inform drug pricing decisions in Jordan. Value in Health, 2016; 19(2): 233-8.
26- Rabarison KM, Bish CL, Massoudi MS, Giles WH. Economic evaluation enhances public health decision making. Frontiers in public health, 2015; 3: 164.
27- Evers S, Salvador–Carulla L, Halsteinli V, McDaid D, Group M. Implementing mental health economic evaluation evidence: building a bridge between theory and practice. Journal of Mental Health, 2007; 16(2): 223-41.
28- Gumbs PD, Verschuren MW, Mantel-Teeuwisse AK, de Wit AG, de Boer A, Klungel OH. Economic Evaluations of Cholesterol-Lowering Drugs. Pharmacoeconomics, 2007; 25(3): 187-99.
29- Grosios K, Gahan PB, Burbidge J. Overview of healthcare in the UK. EPMA Journal, 2010; 1(4): 529-34.
30- Macarthur D. Pharmaceutical pricing and reimbursement in the United Kingdom. HEPAC Health Economics in Prevention and Care, 2000; 1(1): 47-50.
31- Healy J, Sharman E, Lokuge B, Organization WH. Australia: Health system review; 2006.
32- Armstrong BK, Gillespie JA, Leeder SR, Rubin GL, Russell LM. Challenges in health and health care for Australia. Medical Journal of Australia, 2007; 187(9): 485-9.
33- Barati Marnani A, Nabilo B. AComparative study of the organizational superiority model in Health care at selected countries proposing a model for Iran. Journal of Health Administration, 2005; 7(18): 14-9.
34- Ahmadi m, jalali r, Raiszadeh m. Seven years of experience in the health system transformation plan in Iran: a comparative study and narrative review. Quarterly Journal of Nersing Management, 2021; 10(1): 119-29.
35- Ridic G, Gleason S, Ridic O. Comparisons of health care systems in the United States, Germany and Canada. Materia socio-medica, 2012; 24(2): 112.
36- Busse R, Riesberg A, Organization WH. Health care systems in transition: Germany; 2004.
37- Marchildon GP, Allin S, Merkur S. Canada: Health system review. Health Systems in Transition, 2020; 22(3).
38- Riedel R, Repschläger U, Griebenow R, Breitkopf S, Schmidt S, Guhl A. International standards for health economic evaluation with a focus on the German approach. Journal of clinical pharmacy and therapeutics, 2013; 38(4): 277-85.
39- Stevens A. Pharmaceutical pricing and reimbursement policies in Australia. mimeo; 2000.
40- Haas M, Viney R, Gallego G. Implementing guidelines for reimbursement in Australia: how the PBAC and MSAC use comparative cost-effectiveness. Sydney (NSW): Centre for Health Economics (CHERE)/University of Technology Sydney; 2006.
41- Miners JO, Rowland A, Novak JJ, Lapham K, Goosen TC. Evidence-based strategies for the characterisation of human drug and chemical glucuronidation in vitro and UDP-glucuronosyltransferase reaction phenotyping. Pharmacology & Therapeutics, 2021; 218: 107.
42- Wood K, Giannopoulos V, Louie E, Baillie A, Uribe G, Lee KS, et al. The role of clinical champions in facilitating the use of evidence-based practice in drug and alcohol and mental health settings: A systematic review. Implementation Research and Practice, 2020; 1: 262.
43- Salas-Vega S, Bertling A, Mossialos E. A comparative study of drug listing recommendations and the decision-making process in Australia, the Netherlands, Sweden, and the UK. Health Policy, 2016; 120(10): 1104-14.
44- Tay Wee Teck JB, Baldacchino A. Why Do Different Forms of Knowledge Matter in Evidence-Based Drug Policy? : American Public Health Association; 2022: S140-S2.
45- Paris V, Docteur E. Pharmaceutical pricing and reimbursement policies in Germany; 2008.
46- Danzon PM, Ketcham JD, editors. Reference pricing of pharmaceuticals for Medicare: evidence from Germany, The Netherlands, and New Zealand. Forum for health economics & policy; 2004: De Gruyter.
47- Vandersluis S, Reid JC, Orlando L, Bhatia M. Evidence-based support for phenotypic drug discovery in acute myeloid leukemia. Drug Discovery Today; 2022: 103407.
48- Wenzl M, Paris V. Pharmaceutical reimbursement and pricing in Germany. OECD (Ed), 2018;1:22.
49- Paris V, Belloni A. Value in pharmaceutical pricing. 2013.
50- Masoudi Asl I, Hasanzadeh E, Raeissi p. Determining the Sources of Evidence Used in Decision Making of Staff Managers in Iran University of Medical Sciences:2019. Journal of Health Administration, 2021; 23(4): 61-9.
_||_1- Gröne O, Garcia-Barbero M. Integrated care: a position paper of the WHO European office for integrated health care services. International journal of integrated care, 2001;1.
2- Organization WH. Choosing Interventions that are Cost-Effective (WHO-CHOICE). Geneva: World Health Organization; 2012.
3- Yan R. Cost-effective Intervention: Innovative Strategies for Public Health Care: Pennsylvania State University; 2014.
4- Weinstein MC, Skinner JA. Comparative effectiveness and health care spending—implications for reform. New England Journal of Medicine, 2010; 362(5): 460-5.
5- GROL R. Between evidence-based practice and total quality management: the implementation of cost-effective care. International Journal for Quality in Health Care, 2000; 12(4): 297-304.
6- Harrison S. The politics of evidence-based medicine in the United Kingdom. Policy & Politics, 1998; 26(1): 15-31.
7- García Del Junco J, De Reyna Zaballa R, García Álvarez de Perea J. Evidence-based administration for decision making in the framework of knowledge strategic management. The Learning Organization, 2010; 17(4): 343-63.
8- Walshe K, Rundall TG. Evidence-based management: From theory to practice in health care. The Milbank Quarterly, 2001; 79(3): 429-57.
9- Kovner AR, Fine DJ, D'Aquila R. Evidence-based management in healthcare: Health Administration Press; 2009.
10- White KR, Lemak CH, Griffith JR. Improving healthcare management education using principles from Baldrige and evidence-based management. Journal of Health Administration Education, 2011; 28(3): 187-207.
11- Hofmann PBDF. The Ethics of Evidence-Based Management. Healthcare Executive, 2010; 25(1): 48-51.
12- Stewart R. Evidence-based management: a practical guide for health professionals: Radcliffe Publishing; 2002.
13- Hamlin B. In Support of Evidence-Based Healthcare Management: an empirical study of managerial effectiveness within an NHS trust hospital: Management Research Centre, Wolverhampton Business School; 2001.
14- Hewison A. Evidence-based management in the NHS: is it possible? Journal of Health Organization and Management, 2004; 18(5): 336-48.
15- Muir Gray J. Evidence-based healthcare: how to make health policy and management decisions. London: Churchill Livingstone, 1997; 53.
16- Asante AD, Zwi AB. Factors influencing resource allocation decisions and equity in the health system of Ghana. Public Health, 2009; 123(5): 371-7.
17- Manning J. Exceptional circumstances schemes and the social factors exclusion in healthcare rationing. Oxford University Commonwealth Law Journal, 2013; 13(1): 75-114.
18- Samanta A, Samanta J. Evidence-based medicine: A clinical governance tool for rationalising or rationing health care? Clinical Governance: An International Journal, 2005; 10(4): 308-13.
19- Buse K, Mays N, Walt G. Making health policy: McGraw-Hill Education (UK); 2012.
20- Bastani P, Kavosi Z, Poori SA, Nasab MHI. Evidence-based policy and decision-making among health managers: a case of Shiraz University of Medical Sciences. Galen Medical Journal, 2017; 6(1): 30-8.
21- Packer M, Metra M. Guideline‐directed medical therapy for heart failure does not exist: a non‐judgmental framework for describing the level of adherence to evidence‐based drug treatments for patients with a reduced ejection fraction. European Journal of Heart Failure, 2020; 22(10): 1759-67.
22- Imani Nasab MH, Seyedin SH, Majdzadeh SR, Yazdizadeh B, Salehi M. Factors Affecting the Development of Evidence-Based Health Policy Papers at the Ministry of Health Care and Medical Education. Journal of Health Administration, 2015; 18(60): 105-17.
23- Chisholm D, Evans DB. Economic evaluation in health: saving money or improving care? Journal of Medical Economics, 2007; 10(3): 325-37.
24- Chalkidou K, Culyer AJ. Making choices on the journey to universal health care coverage: from advocacy to analysis. Value in Health, 2016; 19(8): 910-2.
25- Hammad EA. The use of economic evidence to inform drug pricing decisions in Jordan. Value in Health, 2016; 19(2): 233-8.
26- Rabarison KM, Bish CL, Massoudi MS, Giles WH. Economic evaluation enhances public health decision making. Frontiers in public health, 2015; 3: 164.
27- Evers S, Salvador–Carulla L, Halsteinli V, McDaid D, Group M. Implementing mental health economic evaluation evidence: building a bridge between theory and practice. Journal of Mental Health, 2007; 16(2): 223-41.
28- Gumbs PD, Verschuren MW, Mantel-Teeuwisse AK, de Wit AG, de Boer A, Klungel OH. Economic Evaluations of Cholesterol-Lowering Drugs. Pharmacoeconomics, 2007; 25(3): 187-99.
29- Grosios K, Gahan PB, Burbidge J. Overview of healthcare in the UK. EPMA Journal, 2010; 1(4): 529-34.
30- Macarthur D. Pharmaceutical pricing and reimbursement in the United Kingdom. HEPAC Health Economics in Prevention and Care, 2000; 1(1): 47-50.
31- Healy J, Sharman E, Lokuge B, Organization WH. Australia: Health system review; 2006.
32- Armstrong BK, Gillespie JA, Leeder SR, Rubin GL, Russell LM. Challenges in health and health care for Australia. Medical Journal of Australia, 2007; 187(9): 485-9.
33- Barati Marnani A, Nabilo B. AComparative study of the organizational superiority model in Health care at selected countries proposing a model for Iran. Journal of Health Administration, 2005; 7(18): 14-9.
34- Ahmadi m, jalali r, Raiszadeh m. Seven years of experience in the health system transformation plan in Iran: a comparative study and narrative review. Quarterly Journal of Nersing Management, 2021; 10(1): 119-29.
35- Ridic G, Gleason S, Ridic O. Comparisons of health care systems in the United States, Germany and Canada. Materia socio-medica, 2012; 24(2): 112.
36- Busse R, Riesberg A, Organization WH. Health care systems in transition: Germany; 2004.
37- Marchildon GP, Allin S, Merkur S. Canada: Health system review. Health Systems in Transition, 2020; 22(3).
38- Riedel R, Repschläger U, Griebenow R, Breitkopf S, Schmidt S, Guhl A. International standards for health economic evaluation with a focus on the German approach. Journal of clinical pharmacy and therapeutics, 2013; 38(4): 277-85.
39- Stevens A. Pharmaceutical pricing and reimbursement policies in Australia. mimeo; 2000.
40- Haas M, Viney R, Gallego G. Implementing guidelines for reimbursement in Australia: how the PBAC and MSAC use comparative cost-effectiveness. Sydney (NSW): Centre for Health Economics (CHERE)/University of Technology Sydney; 2006.
41- Miners JO, Rowland A, Novak JJ, Lapham K, Goosen TC. Evidence-based strategies for the characterisation of human drug and chemical glucuronidation in vitro and UDP-glucuronosyltransferase reaction phenotyping. Pharmacology & Therapeutics, 2021; 218: 107.
42- Wood K, Giannopoulos V, Louie E, Baillie A, Uribe G, Lee KS, et al. The role of clinical champions in facilitating the use of evidence-based practice in drug and alcohol and mental health settings: A systematic review. Implementation Research and Practice, 2020; 1: 262.
43- Salas-Vega S, Bertling A, Mossialos E. A comparative study of drug listing recommendations and the decision-making process in Australia, the Netherlands, Sweden, and the UK. Health Policy, 2016; 120(10): 1104-14.
44- Tay Wee Teck JB, Baldacchino A. Why Do Different Forms of Knowledge Matter in Evidence-Based Drug Policy? : American Public Health Association; 2022: S140-S2.
45- Paris V, Docteur E. Pharmaceutical pricing and reimbursement policies in Germany; 2008.
46- Danzon PM, Ketcham JD, editors. Reference pricing of pharmaceuticals for Medicare: evidence from Germany, The Netherlands, and New Zealand. Forum for health economics & policy; 2004: De Gruyter.
47- Vandersluis S, Reid JC, Orlando L, Bhatia M. Evidence-based support for phenotypic drug discovery in acute myeloid leukemia. Drug Discovery Today; 2022: 103407.
48- Wenzl M, Paris V. Pharmaceutical reimbursement and pricing in Germany. OECD (Ed), 2018;1:22.
49- Paris V, Belloni A. Value in pharmaceutical pricing. 2013.
50- Masoudi Asl I, Hasanzadeh E, Raeissi p. Determining the Sources of Evidence Used in Decision Making of Staff Managers in Iran University of Medical Sciences:2019. Journal of Health Administration, 2021; 23(4): 61-9.