BACKGROUND It is a familiar story. A promising multiple sclerosis (MS) treatment clears the three regulatory hurdles of safety, quality and efficacy, only to fall at the fourth: cost-effectiveness. This has led to concerns about the validity of the measures typically used to quantify treatment effects in cost-effectiveness analyses and in 2012, in the United Kingdom, the National Institute for Health and Care Excellence called for an improvement in the cost-effectiveness framework for assessing MS treatments. OBJECTIVE AND METHODS This review describes what is meant by cost-effectiveness in health/social care funding decision-making, and usual practice for assessing treatment benefits. RESULTS We detail the use of the quality-adjusted life-year (QALY) in resource allocation decisions, and set out limitations of this approach in the context of MS. CONCLUSION We conclude by highlighting methodological and policy developments which should aid addressing these limitations.

中文翻译：

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衡量多发性硬化症患者治疗的成本效益：超越质量调整生命年

背景 这是一个熟悉的故事。一种有前途的多发性硬化症 (MS) 治疗清除了安全性、质量和有效性这三个监管障碍，只落在第四个：成本效益。这导致人们担心成本效益分析中通常用于量化治疗效果的措施的有效性，2012 年，在英国，国家健康和护理卓越研究所呼吁改进成本效益框架评估 MS 治疗。目标和方法 本综述描述了健康/社会保健资助决策中成本效益的含义，以及评估治疗益处的常规做法。结果 我们详细说明了质量调整生命年 (QALY) 在资源分配决策中的使用，并列出了这种方法在 MS 情况下的局限性。