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药物不良反应(ADRs)是引起住院的常见原因,往往造成极大的社会成本。然而,由于大多数ADRs从未引起过临床的重视,所以住院治疗的成本仅仅是由ADRs所造成的社会总成本中的一部分。与ADRs相关的成本主要有两项:为治疗由ADRs引起的疾病而产生的成本以及为避免发生ADRs而产生的成本。本文主要从经济学的角度来讨论ADRs的社会成本。通过文献回顾并对其中有关ADRs发生和其成本的研究文献进行总结后,得出如下3种评价ADRs成本的不同方法:第一种方法是成本研究,必须通过以下三步来估算ADRs的成本:(1)定义ADRs;(2)判断是否为ADRs;(3)测算ADRs的成本。大多数有关成本的研究主要集中在由ADRs所引起的住院治疗上,并且文献显示所有住院治疗中约有3%～7%是由ADRs引起的。第二种方法是关于安全性的成本和效益。对处方、使用、调剂或者生产某药物,在决策涉及到成本和效益时,决策者必须对如下两方面成本进行权衡:(1)为治疗由ADRs引起的疾病而产生的成本;(2)为避免发生ADRs而产生的成本。第三种方法是讨论使药物治疗的成本和效益之间达到最佳平衡所需的法规和机制。从经济学的角度讲,ADRs的问题不是最小化而是最优化问题,是在成本和效益之间找到恰当的平衡关系。
Adverse drug reactions (ADRs) are common causes of hospitalization and often result in significant social costs. However, since most ADRs have never received any clinical attention, the cost of hospitalization is only part of the total social costs of ADRs. The costs associated with ADRs are twofold: the costs of treating the disease caused by ADRs and the costs of avoiding ADRs. This article discusses the social costs of ADRs primarily from an economic point of view. After reviewing the literature and reviewing the literature on the incidence and cost of ADRs, there are three different ways to evaluate the cost of ADRs: The first is a cost study and the cost of ADRs must be estimated in three steps: (1) define ADRs; (2) determine whether ADRs; (3) measure the cost of ADRs. Much of the cost-related research has focused on hospitalizations caused by ADRs, and the literature shows that about 3% to 7% of all hospitalizations are caused by ADRs. The second method is about the costs and benefits of security. In the case of prescription, use, dispensing or manufacturing of a drug, when it comes to costs and benefits in decision making, the decision maker must weigh the costs of (1) the costs of treating the disease caused by ADRs, (2) Avoid the costs of developing ADRs. The third method is to discuss the laws and mechanisms needed to achieve the best balance between the costs and benefits of drug treatment. From an economic point of view, the problem of ADRs is not to minimize but to optimize the problem, is to find the right balance between cost and benefit.