{"id":16718,"date":"2026-09-07T15:00:00","date_gmt":"2026-09-07T05:00:00","guid":{"rendered":"https:\/\/geoffreychen.com\/?p=16718"},"modified":"2026-09-07T15:00:00","modified_gmt":"2026-09-07T05:00:00","slug":"qaly-pbs-no-fixed-threshold","status":"publish","type":"post","link":"https:\/\/geoffreychen.com\/zh\/qaly-pbs-no-fixed-threshold\/","title":{"rendered":"\u4e00\u4e2aQALY\u503c\u591a\u5c11\u94b1\uff0c\u4e3a\u4ec0\u4e48PBS\u6ca1\u6709\u516c\u5f00\u7684\u56fa\u5b9a\u6210\u672c\u6548\u76ca\u95e8\u69db\uff1f"},"content":{"rendered":"<\/p>\n<p><em>\u300a\u5f53\u6570\u5b57\u5f00\u59cb\u505a\u51b3\u5b9a\u300b\u00b7 \u7b2c\u56db\u5b63\u201c\u65e0\u6cd5\u76f4\u63a5\u5b9a\u4ef7\u7684\u4e1c\u897f\u201d\u00b7 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Scheme\uff08PBS\uff09\u65f6\uff0c\u4ecd\u8981\u56de\u7b54\u53e6\u4e00\u4e2a\u95ee\u9898\uff1a\u4e0e\u73b0\u6709\u6cbb\u7597\u76f8\u6bd4\uff0c\u8fd9\u4e00\u989d\u5916\u5065\u5eb7\u6536\u76ca\u662f\u5426\u503c\u5f97\u7531\u516c\u5171\u836f\u7269\u9884\u7b97\u627f\u62c5\uff1f<\/p>\n<p>\u8fd9\u4e0d\u662f\u5224\u65ad\u836f\u7269\u201c\u6709\u6ca1\u6709\u7528\u201d\uff0c\u800c\u662f\u5224\u65ad\u600e\u6837\u4f7f\u7528\u5171\u540c\u8d44\u6e90\u3002\u6fb3\u6d32\u6cd5\u5f8b\u8981\u6c42Pharmaceutical Benefits Advisory 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= \u589e\u91cf\u6210\u672c \u00f7 \u589e\u91cfQALY<\/p>\n<\/blockquote>\n<p>PBAC\u6307\u5357\u504f\u597d\u5728\u9002\u5f53\u60c5\u51b5\u4e0b\u4f7f\u7528\u6210\u672c\u6548\u7528\u5206\u6790\u3002\u8fd9\u6837\uff0c\u5ef6\u5bff\u836f\u3001\u6b62\u75db\u836f\u548c\u6539\u5584\u65e5\u5e38\u529f\u80fd\u7684\u6cbb\u7597\uff0c\u81f3\u5c11\u53ef\u4ee5\u5728\u540c\u4e00\u516c\u5171\u9884\u7b97\u4e2d\u6bd4\u8f83\u3002\u6307\u5357\u540c\u65f6\u8981\u6c42\u8bf4\u660e\u4e34\u5e8a\u8bd5\u9a8c\u5982\u4f55\u88ab\u8f6c\u6362\u4e3a\u6a21\u578b\uff1a\u91c7\u7528\u54ea\u4e9b\u5065\u5eb7\u72b6\u6001\u3001\u8f6c\u79fb\u6982\u7387\u3001\u65f6\u95f4\u8303\u56f4\u548c\u6548\u7528\u6743\u91cd\uff0c\u600e\u6837\u628a\u8bd5\u9a8c\u4eba\u7fa4\u63a8\u5230\u6fb3\u6d32\u5b9e\u9645\u60a3\u8005\uff0c\u4ee5\u53ca\u672a\u6765\u6210\u672c\u548c\u7ed3\u679c\u5982\u4f55\u8d34\u73b0\u3002\u5176\u73b0\u884c\u516c\u5f00\u6307\u5357\u7684\u57fa\u7840\u5206\u6790\u8981\u6c42\u5bf9\u8d85\u8fc7\u4e00\u5e74\u7684\u6210\u672c\u548c\u5065\u5eb7\u7ed3\u679c\u4f7f\u7528\u6bcf\u5e745%\u7684\u7edf\u4e00\u8d34\u73b0\u7387\uff0c\u5e76\u75283.5%\u548c0%\u505a\u654f\u611f\u6027\u5206\u6790\u3002<\/p>\n<p>QALY\u7684\u4f18\u70b9\u6b63\u662f\u538b\u7f29\u3002\u6ca1\u6709\u5171\u540c\u5355\u4f4d\uff0c\u9884\u7b97\u53ef\u80fd\u53ea\u5956\u52b1\u5bb9\u6613\u8ba1\u6570\u7684\u751f\u5b58\u671f\uff0c\u5ffd\u7565\u75bc\u75db\u3001\u6d3b\u52a8\u80fd\u529b\u548c\u751f\u6d3b\u8d28\u91cf\uff1b\u4e5f\u53ef\u80fd\u88ab\u836f\u54c1\u7684\u7edd\u5bf9\u4ef7\u683c\u5413\u4f4f\uff0c\u800c\u770b\u4e0d\u89c1\u5b83\u8282\u7701\u7684\u4f4f\u9662\u548c\u5176\u4ed6\u7167\u62a4\u6210\u672c\u3002<\/p>\n<p>\u5b83\u7684\u7f3a\u70b9\u4e5f\u6765\u81ea\u538b\u7f29\u3002\u4e00\u4e2a\u6548\u7528\u6743\u91cd\u600e\u6837\u53d6\u5f97\uff1f\u7531\u4e00\u822c\u516c\u4f17\u8fd8\u662f\u60a3\u8005\u8bc4\u4ef7\uff1f\u77ed\u671f\u4e25\u91cd\u75db\u82e6\u4e0e\u957f\u671f\u8f7b\u5ea6\u9650\u5236\u5982\u4f55\u6bd4\u8f83\uff1f\u7f55\u89c1\u75c5\u7684\u5c0f\u578b\u8bd5\u9a8c\u80fd\u5426\u53ef\u9760\u63a8\u7b97\u7ec8\u8eab\u6536\u76ca\uff1f\u7167\u62a4\u8005\u3001\u5bb6\u5ead\u3001\u6559\u80b2\u548c\u5de5\u4f5c\u5f71\u54cd\u901a\u5e38\u4e0d\u5728\u533b\u7597\u7cfb\u7edf\u57fa\u7840\u89c6\u89d2\u5185\uff0c\u53ea\u80fd\u4f5c\u4e3a\u8865\u5145\u5206\u6790\u3002PBAC\u6307\u5357\u751a\u81f3\u660e\u786e\u6307\u51fa\uff0c\u5355\u4e00\u8d27\u5e01\u6210\u672c\u6548\u76ca\u5206\u6790\u65e0\u6cd5\u6db5\u76d6\u59d4\u5458\u4f1a\u9700\u8981\u8003\u8651\u7684\u5168\u90e8\u56e0\u7d20\u3002<\/p>\n<h2>\u4e09\u3001\u6ca1\u6709\u56fa\u5b9a\u95e8\u69db\uff0c\u4e0d\u8868\u793a\u6570\u5b57\u6ca1\u6709\u6743\u529b<\/h2>\n<p>\u82e5ICER\u8d8a\u9ad8\uff0c\u610f\u5473\u7740\u4e3a\u540c\u6837\u7684\u989d\u5916\u5065\u5eb7\u6536\u76ca\u9700\u8981\u4ed8\u51fa\u66f4\u591a\u8d44\u6e90\uff0c\u83b7\u63a8\u8350\u4e00\u822c\u66f4\u56f0\u96be\u3002\u4f46PBAC\u8fd8\u4f1a\u8003\u8651\u8bc1\u636e\u786e\u5b9a\u6027\u3001\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\u3001\u672a\u6ee1\u8db3\u9700\u8981\u3001\u66ff\u4ee3\u6cbb\u7597\u3001\u60a3\u8005\u7fa4\u89c4\u6a21\u3001\u9884\u7b97\u5f71\u54cd\u3001\u836f\u7269\u6bd2\u6027\u4ee5\u53ca\u9650\u5236\u6761\u4ef6\u80fd\u5426\u628a\u836f\u7269\u7528\u5728\u771f\u6b63\u53d7\u76ca\u8005\u8eab\u4e0a\u3002<\/p>\n<p>\u540c\u6837\u662f6\u4e07\u6fb3\u5143\/QALY\uff0c\u4e00\u79cd\u836f\u53ef\u80fd\u6709\u5927\u578b\u76f4\u63a5\u6bd4\u8f83\u8bd5\u9a8c\uff0c\u6548\u679c\u7a33\u5b9a\u4e14\u80fd\u51cf\u5c11\u4f4f\u9662\uff1b\u53e6\u4e00\u79cd\u836f\u53ef\u80fd\u4f9d\u9760\u77ed\u671f\u66ff\u4ee3\u7ec8\u70b9\u5916\u63a8\u5341\u5e74\u3002\u4e24\u4e2a\u70b9\u4f30\u8ba1\u76f8\u540c\uff0c\u53ef\u4fe1\u7a0b\u5ea6\u4e0d\u540c\u3002\u82e5\u7528\u56fa\u5b9a\u95e8\u69db\u81ea\u52a8\u6279\u51c6\u4e24\u8005\uff0c\u5236\u5ea6\u4f1a\u5047\u88c5\u4e0d\u786e\u5b9a\u6027\u4e0d\u5b58\u5728\uff1b\u82e5\u81ea\u52a8\u62d2\u7edd\u6240\u6709\u9ad8\u4e8e\u95e8\u69db\u7684\u836f\uff0c\u53c8\u53ef\u80fd\u65e0\u6cd5\u56de\u5e94\u7f55\u89c1\u75c5\u3001\u672b\u671f\u75be\u75c5\u6216\u6ca1\u6709\u66ff\u4ee3\u6cbb\u7597\u7684\u60c5\u5f62\u3002<\/p>\n<p>\u4e0d\u8bbe\u7f6e\u5355\u4e00\u786c\u7ebf\u56e0\u6b64\u6709\u5408\u7406\u7406\u7531\u3002\u5b83\u4fdd\u7559\u4e13\u4e1a\u5224\u65ad\u548c\u4ef7\u683c\u8c08\u5224\u7a7a\u95f4\uff1aPBAC\u53ef\u4ee5\u6682\u7f13\u7b49\u5f85\u66f4\u591a\u8d44\u6599\u3001\u5efa\u8bae\u7f29\u5c0f\u9002\u7528\u8303\u56f4\uff0c\u6216\u5728\u8f83\u4f4e\u4ef7\u683c\u4e0b\u8ba4\u4e3a\u836f\u7269\u53ef\u63a5\u53d7\u3002\u653f\u5e9c\u4e0e\u5382\u5546\u7684\u98ce\u9669\u5206\u62c5\u5b89\u6392\u4e5f\u53ef\u4ee5\u5904\u7406\u5b9e\u9645\u7528\u91cf\u6216\u6548\u679c\u7684\u4e0d\u786e\u5b9a\u6027\u3002<\/p>\n<p>\u95ee\u9898\u5728\u4e8e\uff0c\u5f39\u6027\u82e5\u6ca1\u6709\u8db3\u591f\u7406\u7531\uff0c\u5c31\u4f1a\u6210\u4e3a\u4e0d\u53ef\u89c1\u95e8\u69db\u3002\u60a3\u8005\u53ef\u80fd\u53ea\u77e5\u9053\u201c\u6210\u672c\u6548\u76ca\u4e0d\u8db3\u201d\uff0c\u5374\u4e0d\u77e5\u9053\u7ed3\u679c\u5bf9\u836f\u4ef7\u3001\u6548\u7528\u6743\u91cd\u3001\u6cbb\u7597\u671f\u9650\u6216\u8bc1\u636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Public Summary 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Knowing\u3002\u6ca1\u6709\u4efb\u4f55\u4e00\u540d\u59d4\u5458\u80fd\u4eb2\u81ea\u7ecf\u5386\u6240\u6709\u75be\u75c5\uff0c\u4e5f\u6ca1\u6709\u4efb\u4f55\u60a3\u8005\u638c\u63e1\u6574\u4e2aPBS\u9884\u7b97\uff1bQALY\u8ba9\u5206\u6563\u77e5\u8bc6\u88ab\u4fdd\u5b58\u3001\u6bd4\u8f83\u548c\u8c03\u7528\u3002\u4f46\u5f53\u8f93\u51fa\u83b7\u5f97\u6743\u5a01\u65f6\uff0c\u5236\u5ea6\u4ecd\u4e0d\u80fd\u5047\u88c5\u5b83\u7406\u89e3\u4e86\u6bcf\u4e00\u79cd\u751f\u6d3b\u3002\u4e00\u4e2a\u6a21\u578b\u80fd\u591f\u8ba1\u7b97\u201c0.72\u201d\uff0c\u4e0d\u7b49\u4e8e\u5b83\u77e5\u9053\u5931\u53bb\u8bf4\u8bdd\u80fd\u529b\u3001\u72ec\u7acb\u6d17\u6fa1\u6216\u4e0e\u5bb6\u4eba\u76f8\u5904\u5bf9\u67d0\u4eba\u7684\u610f\u4e49\u3002<\/p>\n<p>Commitment as the Human Remainder\u8981\u6c42PBAC\u548c\u653f\u5e9c\u627f\u62c5\u5269\u4f59\u5224\u65ad\uff1a\u4e3a\u4ec0\u4e48\u8fd9\u4e00\u8bc1\u636e\u8db3\u4ee5\u652f\u6301\u8fd9\u4e00\u9650\u5236\uff0c\u4e3a\u4ec0\u4e48\u516c\u5171\u9884\u7b97\u5e94\u627f\u62c5\u6216\u4e0d\u627f\u62c5\u8fd9\u79cd\u4ef7\u683c\uff0c\u4ee5\u53ca\u54ea\u4e9b\u4ef7\u503c\u4e0d\u80fd\u88abQALY\u5b8c\u5168\u8868\u8fbe\u3002\u6ca1\u6709\u56fa\u5b9a\u95e8\u69db\u4f7f\u8fd9\u4efd\u4eba\u7c7b\u8d23\u4efb\u66f4\u91cd\uff0c\u800c\u4e0d\u662f\u66f4\u8f7b\u3002<\/p>\n<h2>\u7ed3\u8bba\uff1a\u4e0d\u8981\u5efa\u7acb\u81ea\u52a8\u836f\u4ef7\u7ebf\uff0c\u8981\u5efa\u7acb\u53ef\u89e3\u91ca\u7684\u5224\u65ad\u533a\u95f4<\/h2>\n<p>\u6211\u7684\u5224\u65ad\u662f\uff0c\u6fb3\u6d32\u4e0d\u5e94\u628a\u6bcfQALY\u56fa\u5b9a\u4e3a\u4e00\u4e2a\u516c\u5f00\u3001\u81ea\u52a8\u6267\u884c\u7684\u4ef7\u683c\u3002\u75be\u75c5\u4e25\u91cd\u6027\u3001\u8bc1\u636e\u8d28\u91cf\u3001\u66ff\u4ee3\u6cbb\u7597\u3001\u60a3\u8005\u89c4\u6a21\u548c\u672a\u6355\u6349\u7ed3\u679c\u5dee\u5f02\u592a\u5927\uff0c\u786c\u7ebf\u4f1a\u5236\u9020\u865a\u5047\u516c\u5e73\u3002\u4f46\u201c\u4e0d\u8bbe\u786c\u7ebf\u201d\u4e0d\u80fd\u6210\u4e3a\u6a21\u7cca\u51b3\u5b9a\u7684\u8bb8\u53ef\u8bc1\u3002<\/p>\n<p>PBAC\u5e94\u7ee7\u7eed\u4f7f\u7528QALY\u4e0eICER\u4f5c\u4e3a\u6838\u5fc3\u6bd4\u8f83\u5de5\u5177\uff0c\u540c\u65f6\u66f4\u6e05\u695a\u5730\u516c\u5f00\u533a\u95f4\u3001\u4e3b\u8981\u5047\u8bbe\u3001\u5206\u7ec4\u5f71\u54cd\u3001\u8865\u5145\u60a3\u8005\u7ed3\u679c\u548c\u7ed3\u8bba\u6539\u53d8\u6761\u4ef6\u3002\u8d8a\u63a5\u8fd1\u59d4\u5458\u4f1a\u5b9e\u9645\u53ef\u63a5\u53d7\u8303\u56f4\uff0c\u8d8a\u5e94\u5141\u8bb8\u4ef7\u683c\u8c08\u5224\u3001\u8865\u5145\u8bc1\u636e\u548c\u6761\u4ef6\u6027\u8d44\u52a9\uff0c\u800c\u4e0d\u662f\u628a\u4e00\u4e2a\u4e0d\u7a33\u5b9a\u70b9\u4f30\u8ba1\u5199\u6210\u6700\u7ec8\u4e8b\u5b9e\u3002<\/p>\n<p>QALY\u53ef\u4ee5\u5e2e\u52a9\u516c\u5171\u5236\u5ea6\u95ee\uff1a\u82b1\u540c\u6837\u8d44\u6e90\uff0c\u80fd\u4ea7\u751f\u591a\u5c11\u5065\u5eb7\u6536\u76ca\uff1f\u5b83\u4e0d\u80fd\u72ec\u81ea\u56de\u7b54\uff1a\u8c01\u7684\u751f\u6d3b\u503c\u5f97\u88ab\u5171\u540c\u627f\u62c5\u3002\u540e\u4e00\u4e2a\u95ee\u9898\u5fc5\u987b\u7531\u80fd\u591f\u8bf4\u660e\u7406\u7531\u3001\u63a5\u53d7\u590d\u6838\u5e76\u6839\u636e\u73b0\u5b9e\u7ed3\u679c\u4fee\u6b63\u7684\u516c\u5171\u673a\u6784\u4f5c\u51fa\u3002<\/p>\n<h3>\u4e3b\u8981\u8d44\u6599<\/h3>\n<ul>\n<li><a href=\"https:\/\/pbac.pbs.gov.au\/section-3a\/3a-1-overview-and-rationale-of-economic-evaluation.html\" target=\"_blank\" rel=\"noopener\">PBAC Guidelines\uff1aOverview and rationale of the economic evaluation<\/a><\/li>\n<li><a href=\"https:\/\/www.pbs.gov.au\/info\/industry\/listing\/participants\/pbac\" target=\"_blank\" rel=\"noopener\">PBS\uff1aPBAC membership and functions<\/a><\/li>\n<li><a href=\"https:\/\/www.pbs.gov.au\/info\/industry\/listing\/procedure-guidance\/7-post-pbac-decision-procedures-sponsors\/7-4-public-summary-documents\" target=\"_blank\" rel=\"noopener\">PBS\uff1aPublic Summary Documents<\/a><\/li>\n<li><a href=\"https:\/\/www.pbs.gov.au\/info\/general\/working-groups\/amwg\/amwg-interim-report-attachment-b\" target=\"_blank\" rel=\"noopener\">PBS\uff1aManaging Uncertainty in the Assessment of Medicines\uff082008\uff0c\u5386\u53f2\u8d44\u6599\uff09<\/a><\/li>\n<li><a href=\"https:\/\/www.health.gov.au\/resources\/publications\/health-technology-assessment-policy-and-methods-review-final-report\" target=\"_blank\" rel=\"noopener\">\u6fb3\u6d32\u536b\u751f\u3001\u6b8b\u969c\u4e0e\u8001\u9f84\u4e8b\u52a1\u90e8\uff1aHealth Technology Assessment Policy and Methods Review\u2014Final Report<\/a><\/li>\n<\/ul>\n<p>","protected":false},"excerpt":{"rendered":"","protected":false},"author":17897162,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_geoff_meta_description_en":"","_geoff_meta_description_zh":"","_wpcom_ai_launchpad_first_post":false,"_jetpack_hide_featured_image":false,"_jetpack_featured_image_duplicate_dismissed":0,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[787296231],"tags":[787296239,787296238,787296240,787296241,787296232,787296032,787296033,787296235],"class_list":["post-16718","post","type-post","status-publish","format-standard","hentry","category-things-that-cannot-be-priced-directly","tag-pharmaceutical-benefits-scheme-zh","tag-qaly-zh","tag-pharmaceutical-benefits-scheme","tag-qaly","tag-things-that-cannot-be-priced-directly","tag-when-numbers-start-making-decisions","tag-when-numbers-start-making-decisions-zh","tag-things-that-cannot-be-priced-directly-zh",""],"translatepress_titles":{"en_AU":"How 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