{"id":123,"date":"2019-02-28T13:00:27","date_gmt":"2019-02-28T04:00:27","guid":{"rendered":"https:\/\/info.zanet.biz\/?p=123"},"modified":"2019-02-28T22:03:24","modified_gmt":"2019-02-28T13:03:24","slug":"%e6%88%91%e3%81%8c%e5%9b%bd%e3%81%ae%e5%8c%bb%e7%99%82%e7%b5%8c%e6%b8%88%e8%a9%95%e4%be%a1%e3%81%b8%e3%81%ae%e5%8f%96%e3%82%8a%e7%b5%84%e3%81%bf%ef%bc%9a%e6%8a%80%e8%a1%93%e7%9a%84%e6%96%b9%e6%b3%95","status":"publish","type":"post","link":"https:\/\/info.zanet.biz\/?p=123","title":{"rendered":"\u6211\u304c\u56fd\u306e\u533b\u7642\u7d4c\u6e08\u8a55\u4fa1\u3078\u306e\u53d6\u308a\u7d44\u307f\uff1a\u6280\u8853\u7684\u65b9\u6cd5\u8ad6"},"content":{"rendered":"\n<p> \u539a\u751f\u52b4\u50cd\u7701\u306e\u653f\u7b56\u79d1\u5b66\u7dcf\u5408\u7814\u7a76\u4e8b\u696d\uff08\u653f\u7b56\u79d1\u5b66\u63a8\u9032\u7814\u7a76\u4e8b\u696d\uff09\u300c\u533b\u7642\u7d4c\u6e08\u8a55\u4fa1\u306e\u653f\u7b56 \u5fdc\u7528\u306b\u5411\u3051\u305f\u8a55\u4fa1\u624b\u6cd5\u304a\u3088\u3073\u30c7\u30fc\u30bf\u306e\u78ba\u7acb\u3068\u8a55\u4fa1\u4f53\u5236\u306e\u6574\u5099\u306b\u95a2\u3059\u308b\u7814\u7a76\u300d\u73ed \u306b\u3088\u308b\u300c<strong>\u8cbb\u7528\u5bfe\u52b9\u679c\u8a55\u4fa1\u306e\u5206\u6790\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u6539\u5b9a\u6848\u306b\u3064\u3044\u3066<\/strong>\u300d\u304c\u516c\u958b\u3055\u308c\u3066\u3044\u307e\u3059\u3002 <\/p>\n\n\n\n<p>\u3053\u308c\u306f\u3001\u4e2d\u533b\u5354\uff08\u8cbb\u7528\u5bfe\u52b9\u679c\u8a55\u4fa1\u30fb\u85ac\u4fa1\u30fb\u4fdd\u5065\u533b\u7642\u6750\u6599\u3000\u5c02\u9580\u90e8\u4f1a\u5408\u540c\u90e8\u4f1a\uff09\u306e2019\u5e741\u670823\u65e5 <a href=\"http:\/\/gmmi.jp.net\/material-all\/documents-mhlw\/7066\/\">\u539a\u751f\u52b4\u50cd\u7701\u8cc7\u6599<\/a>\u306e\u4e2d\u306e&nbsp;\u3001\u4e2d\u592e\u793e\u4f1a\u4fdd\u967a\u533b\u7642\u5354\u8b70\u4f1a\u8cbb\u7528\u5bfe\u52b9\u679c\u8a55\u4fa1\u5c02\u9580\u90e8\u4f1a\u30fb\u85ac\u4fa1\u5c02\u9580\u90e8\u4f1a\u30fb\u4fdd\u967a\u533b\u7642\u6750\u6599\u5c02\u9580\u90e8\u4f1a\u5408\u540c\u90e8\u4f1a\uff08\u7b2c15\u56de\uff09<a href=\"http:\/\/\ufeffhttps:\/\/www.mhlw.go.jp\/stf\/shingi2\/0000211220_00010.html\">\u8b70<\/a><a href=\"https:\/\/www.mhlw.go.jp\/stf\/shingi2\/0000211220_00010.html\">\u4e8b\u6b21\u7b2c<\/a>\u306b\u542b\u307e\u308c\u3066\u3044\u307e\u3059\u3002\u8cbb\u85ac\u6750\uff0d\uff13\uff08PDF\uff1a455KB\uff09\u3068\u3057\u3066PDF\u30d5\u30a1\u30a4\u30eb\u3092<a href=\"https:\/\/www.mhlw.go.jp\/content\/12404000\/000472480.pdf\ufeff\">\u30c0\u30a6\u30f3\u30ed\u30fc\u30c9<\/a>\u3067\u304d\u307e\u3059\u3002<\/p>\n\n\n\n<p> \u3053\u306e\u8cbb\u7528\u5bfe\u52b9\u679c\u8a55\u4fa1\u306e\u5206\u6790\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u6539\u5b9a\u6848\u300d\u304b\u3089\u91cd\u8981\u3068\u601d\u308f\u308c\u308b\u70b9\u3092\u4e00\u90e8\u629c\u7c8b\u3057\u3066\u4ee5\u4e0b\u306b\u8a18\u8ff0\u3057\u307e\u3059\u3002\u3053\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f\u6848\u3067\u3042\u308b\u3053\u3068\u3092\u8a8d\u8b58\u3057\u305f\u4e0a\u3067\u3001\u307e\u305f\u4ee5\u4e0b\u306e\u8a18\u8ff0\u306f\u629c\u7c8b\u306a\u306e\u3067\u3082\u3057\u5404\u81ea\u304c\u8a55\u4fa1\u3057\u305f\u3044\u5834\u5408\u306f\u5fc5\u305a\u4e0a\u8a18\u306e\u30ea\u30f3\u30af\u304b\u3089\u5168\u6587\u3092\u5f97\u3066\u719f\u8aad\u3057\u3066\u304b\u3089\u3057\u3066\u4e0b\u3055\u3044\u3002<\/p>\n\n\n\n<p>1.1 \u672c\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f\u3001\u4e2d\u592e\u793e\u4f1a\u4fdd\u967a\u533b\u7642\u5354\u8b70\u4f1a\u306b\u304a\u3044\u3066\u3001\u8a55\u4fa1\u5bfe\u8c61\u3068\u3057\u3066\u9078\u5b9a\u3055\u308c\u305f\u533b\u85ac \u54c1\uff65\u533b\u7642\u6a5f\u5668(\u4ee5\u4e0b\u3001\u8a55\u4fa1\u5bfe\u8c61\u6280\u8853)\u306e\u8cbb\u7528\u5bfe\u52b9\u679c\u8a55\u4fa1\u3092\u5b9f\u65bd\u3059\u308b\u306b\u3042\u305f\u3063\u3066\u7528\u3044\u308b\u3079\u304d\u5206 \u6790\u65b9\u6cd5\u3092\u63d0\u793a\u3057\u3066\u3044\u308b\u3002<br>2.2 \u8cbb\u7528\u3084\u6bd4\u8f03\u5bfe\u7167\u6280\u8853\u3001\u5bfe\u8c61\u96c6\u56e3\u306a\u3069\u306b\u3064\u3044\u3066<strong>\u516c\u7684\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u306e\u7bc4\u56f2\u3067\u5b9f\u65bd\u3059\u308b \u300c\u516c\u7684\u533b\u7642\u306e\u7acb\u5834\u300d<\/strong>\u3092\u57fa\u672c\u3068\u3059\u308b\u3002<br>5.1 \u8cbb\u7528\u5bfe\u52b9\u679c\u3092\u691c\u8a0e\u3059\u308b\u306b\u3042\u305f\u3063\u3066\u306f\u3001\u8a55\u4fa1\u5bfe\u8c61\u6280\u8853\u306e<strong>\u6bd4\u8f03\u5bfe\u7167\u306b\u5bfe\u3059\u308b\u8ffd\u52a0\u7684\u306a\u6709\u7528 \u6027\u306e\u6709\u7121\u3092\u8a55\u4fa1\u3059\u308b<\/strong>\u3002<br>6.1 \u52b9\u679c\u3092\u91d1\u92ad\u63db\u7b97\u305b\u305a\u3001<strong>\u8cbb\u7528\u3068\u52b9\u679c\u3092\u5225\u3005\u306b\u63a8\u8a08\u3059\u308b\u8cbb\u7528\u52b9\u679c\u5206\u6790\u3092\u5206\u6790\u624b\u6cd5\u3068\u3057\u3066\u7528 \u3044\u308b\u3053\u3068\u3092\u539f\u5247\u3068\u3059\u308b<\/strong>\u3002&nbsp;&nbsp;<br>6.2 \u300c5.\u300d\u306e\u5206\u6790\u306b\u57fa\u3065\u304d\u3001\u8ffd\u52a0\u7684\u6709\u7528\u6027\u304c\u793a\u3055\u308c\u3066\u3044\u308b\u3068\u5224\u65ad\u3055\u308c\u308b\u5834\u5408\u306b\u306f\u3001\u5404\u7fa4\u306e\u671f \u5f85\u8cbb\u7528\u3068\u671f\u5f85\u52b9\u679c\u304b\u3089<strong>\u5897\u5206\u8cbb\u7528\u52b9\u679c\u6bd4(Incremental cost-effectiveness ratio: ICER)<\/strong> \u3092\u7b97\u51fa\u3059\u308b\u3002<br>6.3.1 \u5bfe\u7167\u6280\u8853\u3068\u6bd4\u3079\u3066\u52b9\u679c\u304c\u540c\u7b49\u4ee5\u4e0a(\u5897\u5206\u52b9\u679c\u306e\u5927\u304d\u3055\u304c\u975e\u8ca0)\u3067\u3001\u304b\u3064\u8cbb \u7528\u304c\u5b89\u3044\u5834\u5408\u3002\u3053\u306e\u3068\u304d\u3001ICER \u3092\u7b97\u51fa\u305b\u305a\u306b\u512a\u4f4d(dominant)\u3067\u3042\u308b\u3068\u3059\u308b\u3002<br>6.3.2 \u5bfe\u7167\u6280\u8853\u3068\u6bd4\u3079\u3066\u52b9\u679c\u304c\u540c\u7b49\u4ee5\u4e0b(\u5897\u5206\u52b9\u679c\u306e\u5927\u304d\u3055\u304c\u975e\u6b63)\u3067\u3001\u304b\u3064\u8cbb \u7528\u304c\u9ad8\u3044\u5834\u5408\u3002\u3053\u306e\u3068\u304d\u3001ICER \u3092\u7b97\u51fa\u305b\u305a\u306b\u52a3\u4f4d(dominated)\u3067\u3042\u308b\u3068\u3059\u308b\u3002<br>6.3.3 \u300c5.\u300d\u306e\u5206\u6790\u306b\u3088\u308a\u3001\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u540c\u7b49\u3068\u8003\u3048\u3089\u308c\u308b\u3082\u306e\u306e\u3001\u8ffd\u52a0\u7684\u6709\u7528\u6027\u3092 \u6709\u3059\u308b\u3068\u5224\u65ad\u3067\u304d\u306a\u3044\u5834\u5408\u306b\u306f\u3001\u6bd4\u8f03\u5bfe\u7167\u6280\u8853\u3068\u306e\u8cbb\u7528\u3092\u6bd4\u8f03\u3059\u308b\u3002(\u3044\u308f\u3086\u308b\u300c\u8cbb \u7528\u6700\u5c0f\u5316\u5206\u6790(Cost-minimization analysis :CMA)\u300d)<br>7.1 \u8a55\u4fa1\u5bfe\u8c61\u6280\u8853\u306e\u8cbb\u7528\u3084\u52b9\u679c\u306b\u304a\u3088\u307c\u3059\u5f71\u97ff\u3092\u8a55\u4fa1\u3059\u308b\u306e\u306b\u5341\u5206\u306b\u9577\u3044\u5206\u6790\u671f\u9593\u3092\u7528 \u3044\u308b\u3002<br>8.1 \u52b9\u679c\u6307\u6a19\u306f<strong>\u8cea\u8abf\u6574\u751f\u5b58\u5e74(Quality-adjusted life year: QALY)<\/strong>\u3092\u7528\u3044\u308b\u3053\u3068\u3092\u539f\u5247 \u3068\u3059\u308b\u3002<br>8.1.1 QALY \u3092\u7b97\u51fa\u3059\u308b\u3053\u3068\u304c\u56f0\u96e3\u3067\u3042\u308a\u3001\u304b\u3064 CMA \u3092\u5b9f\u65bd\u3059\u308b\u5834\u5408\u306f\u3001\u5354\u8b70\u306b \u304a\u3051\u308b\u4e21\u8005\u306e\u5408\u610f\u306e\u3082\u3068\u3067\u3001QALY \u4ee5\u5916\u306e\u8a55\u4fa1\u5c3a\u5ea6\u3092\u4f7f\u7528\u3059\u308b\u3053\u3068\u3082\u3067\u304d\u308b\u3002<br>8.2 QALY \u3092\u7b97\u51fa\u3059\u308b\u969b\u306e <strong>QOL \u5024<\/strong>\u306f\u3001\u4e00\u822c\u306e\u4eba\u3005\u306e\u4fa1\u5024\u3092\u53cd\u6620\u3057\u305f\u3082\u306e(<strong>\u9078\u597d\u306b\u57fa\u3065\u304f\u5c3a \u5ea6(preference-based measure: PBM<\/strong>)\u3067 \u6e2c \u5b9a \u3057 \u305f \u3082 \u306e \u3001 \u3042 \u308b \u3044 \u306f <strong>\u57fa \u6e96 \u7684 \u8ced \u3051 (Standard gamble: SG)\u6cd5<\/strong>\u3001<strong>\u6642\u9593\u5f97\u5931(Time trade-off: TTO)\u6cd5<\/strong>\u306a\u3069\u306e\u76f4\u63a5\u6cd5\u3067\u6e2c\u5b9a\u3057 \u305f\u3082\u306e)\u3092\u7528\u3044\u308b\u3002\u305f\u3060\u3057\u3001TTO \u3068 SG \u3067\u306e\u6e2c\u5b9a\u5024\u306b\u306f\u7cfb\u7d71\u7684\u306a\u5dee\u304c\u3042\u308b\u53ef\u80fd\u6027\u306b\u3064\u3044\u3066\u7559 \u610f\u3059\u308b\u3053\u3068\u3002<br>10.4 \u5404\u5065\u5eb7\u72b6\u614b\u306e\u8cbb\u7528\u306e\u63a8\u8a08\u306b\u304a\u3044\u3066\u3001\u9069\u5207\u306a\u5834\u5408\u306b\u306f\u3001\u300c10.3\u300d\u306e\u89b3\u70b9\u304b\u3089\u5b9f\u81e8\u5e8a\u3092 \u53cd\u6620\u3057\u305f<strong>\u56fd\u5185\u306b\u304a\u3051\u308b\u30ec\u30bb\u30d7\u30c8\u306e\u30c7\u30fc\u30bf\u30d9\u30fc\u30b9<\/strong>\u3092\u7528\u3044\u308b\u3053\u3068\u3092\u63a8\u5968\u3059\u308b\u3002\u305f\u3060\u3057\u3001\u30ec\u30bb\u30d7\u30c8\u4e0a\u3067 \u5065\u5eb7\u72b6\u614b\u306e\u5b9a\u7fa9\u304c\u56f0\u96e3\u3067\u3042\u308b\u3001\u8a55\u4fa1\u6642\u70b9\u306b\u304a\u3044\u3066\u30c7\u30fc\u30bf\u306e\u5341\u5206\u306a\u84c4\u7a4d\u304c\u306a\u3044\u306a\u3069\u3001\u63a8\u8a08\u306e \u5b9f\u65bd\u304c\u56f0\u96e3\u306a\u5834\u5408\u306f\u305d\u306e\u9650\u308a\u3067\u306f\u306a\u3044\u3002<br>11.1 \u516c\u7684\u4ecb\u8b77\u8cbb\u7528\u3084\u5f53\u8a72\u75be\u60a3\u306b\u3088\u3063\u3066\u4ed5\u4e8b\u7b49\u304c\u3067\u304d\u306a\u3044\u7d50\u679c\u751f\u3058\u308b<strong>\u751f\u7523\u6027\u640d\u5931\u306f\u3001\u57fa\u672c \u5206\u6790\u306b\u304a\u3044\u3066\u306f\u542b\u3081\u306a\u3044<\/strong>\u3002<br>12.1 \u5c06\u6765\u306b\u767a\u751f\u3059\u308b\u8cbb\u7528\u3068\u52b9\u679c\u306f<strong>\u5272\u5f15\u3092\u884c\u3063\u3066\u3001\u73fe\u5728\u4fa1\u5024\u306b\u63db\u7b97<\/strong>\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u3002&nbsp;&nbsp;<br>12.1.1 \u305f\u3060\u3057\u3001\u5206\u6790\u671f\u9593\u304c 1 \u5e74\u4ee5\u4e0b\u3001\u3042\u308b\u3044\u306f\u77ed\u671f\u9593\u3067\u305d\u306e\u5f71\u97ff\u304c\u7121\u8996\u3067\u304d\u308b \u7a0b\u5ea6\u3067\u3042\u308b\u3068\u304d\u306f\u3001\u5272\u5f15\u3092\u884c\u308f\u306a\u304f\u3066\u3082\u3088\u3044\u3002<br>12.2 <strong>\u8cbb\u7528\uff65\u52b9\u679c\u3068\u3082\u306b\u5e74\u7387 2%\u3067\u5272\u5f15<\/strong>\u3092\u884c\u3046\u3053\u3068\u3068\u3059\u308b\u3002<br>12.3 \u5272\u5f15\u7387\u306f\u3001\u611f\u5ea6\u5206\u6790\u306e\u5bfe\u8c61\u3068\u3057\u3001\u8cbb\u7528\uff65\u52b9\u679c\u3092\u540c\u7387\u3067\u5e74\u7387 0%\u304b\u3089 4%\u306e\u7bc4\u56f2\u3067\u5909\u5316 \u3055\u305b\u308b\u3002<br>13.1 \u300c7.\u300d\u306e\u539f\u5247\u306b\u57fa\u3065\u304d\u3001\u4e88\u5f8c\u3084\u5c06\u6765\u8cbb\u7528\u3092\u4e88\u6e2c\u3059\u308b\u305f\u3081\u306b\u6c7a\u5b9a\u6a39\u30e2\u30c7\u30eb\u3001<strong>\u30de\u30eb\u30b3\u30d5\u30e2 \u30c7\u30eb\u7b49\u3092\u7528\u3044\u305f\u30e2\u30c7\u30eb\u5206\u6790<\/strong>\u3092\u884c\u3063\u3066\u3082\u3088\u3044\u3002<br>14.6 <strong>\u78ba\u7387\u7684\u611f\u5ea6\u5206\u6790(Probabilistic sensitivity analysis: PSA)\u3082\u3042\u308f\u305b\u3066\u5b9f\u65bd\u3059\u308b\u3053\u3068 \u304c\u671b\u307e\u3057\u3044<\/strong>\u3002\u305d\u306e\u5834\u5408\u3001\u4f7f\u7528\u3057\u305f\u5206\u5e03\u306b\u3064\u3044\u3066\u3082\u660e\u3089\u304b\u306b\u3059\u308b\u3068\u3068\u3082\u306b\u3001<strong>\u8cbb\u7528\u52b9\u679c\u5e73\u9762\u4e0a\u306e\u6563 \u5e03\u56f3<\/strong>\u3068<strong>\u8cbb\u7528\u52b9\u679c\u53d7\u5bb9\u66f2\u7dda(Cost-effectiveness acceptability curve: CEAC)<\/strong>\u3092\u63d0\u793a\u3059 \u308b\u3002 <\/p>\n\n\n\n<p> \u4ee5\u4e0a\u3001\u8cbb\u7528\u5bfe\u52b9\u679c\u5206\u6790Cost-effectivness analysis (CEA)\u3092\u884c\u3046\u969b\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306e\u4e00\u90e8\u3092\u3042\u304f\u307e\u3067\u3001CEA\u306e\u6280\u8853\u7684\u65b9\u6cd5\u8ad6\u306e\u8996\u70b9\u304b\u3089\u7d39\u4ecb\u3057\u307e\u3057\u305f\u3002<\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u539a\u751f\u52b4\u50cd\u7701\u306e\u653f\u7b56\u79d1\u5b66\u7dcf\u5408\u7814\u7a76\u4e8b\u696d\uff08\u653f\u7b56\u79d1\u5b66\u63a8\u9032\u7814\u7a76\u4e8b\u696d\uff09\u300c\u533b\u7642\u7d4c\u6e08\u8a55\u4fa1\u306e\u653f\u7b56 \u5fdc\u7528\u306b\u5411\u3051\u305f\u8a55\u4fa1\u624b\u6cd5\u304a\u3088\u3073\u30c7\u30fc\u30bf\u306e\u78ba\u7acb\u3068\u8a55\u4fa1\u4f53\u5236\u306e\u6574\u5099\u306b\u95a2\u3059\u308b\u7814\u7a76\u300d\u73ed \u306b\u3088\u308b\u300c\u8cbb\u7528\u5bfe\u52b9\u679c\u8a55\u4fa1\u306e\u5206\u6790\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u6539\u5b9a\u6848\u306b\u3064\u3044\u3066\u300d\u304c\u516c\u958b\u3055\u308c\u3066\u3044 &hellip; <a href=\"https:\/\/info.zanet.biz\/?p=123\" class=\"more-link\"><span class=\"screen-reader-text\">&#8220;\u6211\u304c\u56fd\u306e\u533b\u7642\u7d4c\u6e08\u8a55\u4fa1\u3078\u306e\u53d6\u308a\u7d44\u307f\uff1a\u6280\u8853\u7684\u65b9\u6cd5\u8ad6&#8221; \u306e<\/span>\u7d9a\u304d\u3092\u8aad\u3080<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-123","post","type-post","status-publish","format-standard","hentry","category-cea"],"_links":{"self":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/123","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=123"}],"version-history":[{"count":4,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/123\/revisions"}],"predecessor-version":[{"id":131,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/123\/revisions\/131"}],"wp:attachment":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=123"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=123"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=123"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}