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Hidayati IR, Amalia L, Setiawan M, Padmasawitri TIA, Rokhman MR. Psychometric Measurements of the Adherence to Refills and Medication Scales Among Patients With HIV/AIDS in Indonesia. Value Health Reg Issues 2024; 44:101027. [PMID: 39146691 DOI: 10.1016/j.vhri.2024.101027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/21/2024] [Accepted: 06/20/2024] [Indexed: 08/17/2024]
Abstract
OBJECTIVE This study aimed to conduct a psychometric evaluation of the Adherence to Refills and Medications Scale (ARMS) among patients with HIV/AIDS in Indonesia. METHODS Psychometric analysis was conducted at 2 hospitals and 7 public health centers at the voluntary counseling and testing clinic. Content validity was measured by assessing the relevance and clarity of each ARMS item. Construct validity was also assessed. Reliability was evaluated using internal consistency and test-retest reliability. RESULTS This study involved 11 experts in the assessment of the content validity and 240 participants in the estimation of the construct validity. All ARMS items were generally considered easy to understand and relevant, with scale-level content validity index based on the average method (S-CVI/Ave) of 0.9 (>0.78) and item-level content validity index (I-CVI) in the range from 0.5 to 1 for the relevance level and S-CVI/Ave of 0.95 (>0.78) and I-CVI in the range from 0.8 to 1 for the clarity level. Two items (numbers 2 and 3) were revised based on experts' suggestions to enhance comprehension. Confirmatory factor analysis supported 2 subscales: adherence to taking medications and adherence to refilling prescriptions. Good reliability was supported by internal consistency (Cronbach's α 0.793) and test-retest reliability (intraclass correlation coefficient 0.722) for the overall adherence score. CONCLUSIONS The Indonesian version of ARMS is a valid and reliable medication adherence scale when used in Indonesian patients with HIV/AIDS.
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Affiliation(s)
- Ika Ratna Hidayati
- School of Pharmacy, Institut Teknologi Bandung, Bandung, Indonesia; Pharmacy Department, Faculty of Health Science, Universitas Muhammadiyah Malang, Malang, Indonesia
| | - Lia Amalia
- School of Pharmacy, Institut Teknologi Bandung, Bandung, Indonesia.
| | - Meddy Setiawan
- Faculty of Medicine, Universitas Muhammadiyah Malang, Malang, Indonesia
| | | | - M Rifqi Rokhman
- Department of Global, University of Groningen, Groningen, The Netherlands; Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Liu S, Xia Y, Yang Y, Ming J, Sun H, Wei Y, Chen Y. Mapping of health technology assessment in China: a comparative study between 2016 and 2021. Glob Health Res Policy 2024; 9:4. [PMID: 38229176 PMCID: PMC10790493 DOI: 10.1186/s41256-023-00339-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/09/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Health Technology Assessment (HTA) in China has recently expanded from purely academic research to include policy or decision-oriented practice, especially after HTA evidence was used to update the National Reimbursement Drug List for the first time in 2017. This study aims to identify the progress and challenges of HTA development from 2016 to 2021 and inform policies and decisions to promote further HTA development in China. METHODS We conducted a cross-sectional web-based survey with policy makers, researchers and industry-providers in China in 2016 and 2021 respectively. The 'Mapping of HTA Instrument', was utilized to assess the HTA development across eight domains: Institutionalization, Identification, Priority setting, Assessment, Appraisal, Reporting, Dissemination of findings and conclusions, and Implementation in policy and practice. To reduce the influence of confounders and compare the mapping outcomes between the 2016 and 2021 groups, we conducted 1:1 Propensity Score Matching (PSM). Univariate analysis was conducted to compare the differences between the two groups. The overall results were further compared with those of a mapping study that included ten countries. RESULTS In total, 212 and 255 respondents completed the survey in 2016 and 2021, respectively. The total score of the HTA development level in China in 2021 was higher than that in 2016 before PSM (89.38 versus 83.96). Following PSM, 183 respondents from the 2016 and 2021 groups were matched. Overall, the mean scores for most indicators in the Institutionalization domain and Dissemination domain in 2021 were higher than those in 2016 (P < 0.05). The Appraisal domain in 2021 was more explicit, transparent and replicable than that in 2016 (t = -3.279, P < 0.05). However, the mean scores of most indicators in the Assessment domain were higher in 2016 than those in 2021 (P < 0.05). CONCLUSIONS Our study suggest that the level of HTA development in China progressed significantly from 2016 to 2021. However, before engaging in HTA activities, further efforts are required to enhance the assessment process. For instance, it is important to establish a clear goal and scope for HTA; adapt standardized methodologies for evaluating the performance of systematic reviews or meta-analyses; and provide comprehensive descriptions of the safety, clinical effectiveness, cost, and cost-effectiveness of the assessed technologies, thus improving the development of HTA in China.
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Affiliation(s)
- Shimeng Liu
- School of Public Health, Fudan University, Shanghai, 200032, China
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, 200032, China
| | - Yu Xia
- School of Public Health, Fudan University, Shanghai, 200032, China
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, 200032, China
| | - Yi Yang
- School of Public Health, Fudan University, Shanghai, 200032, China
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, 200032, China
| | - Jian Ming
- School of Public Health, Fudan University, Shanghai, 200032, China
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, 200032, China
| | - Hui Sun
- School of Public Health, Fudan University, Shanghai, 200032, China
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, 200032, China
- Shanghai Health Development Research Center, Shanghai, 201199, China
| | - Yan Wei
- School of Public Health, Fudan University, Shanghai, 200032, China.
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, 200032, China.
| | - Yingyao Chen
- School of Public Health, Fudan University, Shanghai, 200032, China.
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, 200032, China.
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Tamlyn Anne R, Downes M, Simoncini T, Yu Q, Ren M, Wang Y, Graziano CM, Kim K. Evaluating the cost utility of estradiol plus dydrogesterone for the treatment of menopausal women in China. J Med Econ 2024; 27:16-26. [PMID: 38037348 DOI: 10.1080/13696998.2023.2289297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/15/2023] [Indexed: 12/02/2023]
Abstract
AIM Evaluate the cost utility of menopausal hormone therapy for women in China. MATERIALS AND METHODS A bespoke Markov cost utility model was developed to evaluate a cohort of symptomatic perimenopausal women (>45 years) with intact uterus in China in accordance with China's Pharmacoeconomic guideline. Short (5-year) and long (10-year) treatment durations were evaluated over a lifetime model time horizon with 12-month cycle duration. Societal and healthcare payer perspectives were evaluated in the context of a primary care provider/prescriber, outpatient setting with inpatient care for patients with chronic conditions. Disease risk and mortality parameters were derived from focused literature searches, and China Diagnosis-related Group cost data was included. Comprehensive scenario, univariate and probabilistic sensitivity analysis were undertaken along with independent validation. This is the first model to include MHT-related disease risks. RESULTS According to base case results, the total cost for MHT was 22,516$ (150,106¥) and total quality adjusted life years 12.32 versus total cost of no MHT 30,824$ (205,495¥) and total quality adjusted life years 11.16 resulting in a dominant incremental cost effectiveness ratio of -7,184$ (-47,898¥) per QALY. Results hold true over a range of univariate deterministic sensitivity and scenario analyses. Probabilistic analysis showed a 91% probability of being cost effective at a willingness to pay threshold of three times Gross Domestic Product per capita in China. CONCLUSION Contingent on the structure and assumptions of the model, combination of estradiol plus dydrogesterone MHT is potentially cost saving in symptomatic women over the age of 45 years in China.
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Affiliation(s)
| | - Martin Downes
- Centre for Applied Health Economics, Griffith University, Griffith, Australia
| | - Tommaso Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Molecular and Cellular Gynaecological Endocrinology Laboratory (MCGEL), University of Pisa, , Pisa, Italy
- European Menopause and Andropause Society, Geneva, Switzerland
| | - Qi Yu
- Centre of Gynaecological Endocrinology and Reproduction, Peking Union Medical College Hospital, Peking, China
- Asia Pacific Menopause Federation, Devon, United Kingdom of Great Britain and Northern Ireland
| | - Mulan Ren
- Department of Obstetrics and Gynaecology, Southeast University School of Medicine, Nanjing, Jiangsu, China
- Reproductive Centre, Zhongda Hospital Southeast University, Nanjing, Jiangsu, China
- Gynaecologic Endocrinologist Training Base of Chinese Medical Doctor Association, Beijing, China
- Menopause Group, Obstetrics and Gynaecology Society of Chinese Medical Association, Beijing, China
- Jiangsu Obstetrics and Gynaecology Quality Control Centre, Nanjing, Jiangsu, China
- Osteoporosis and Bone Mineral Salt Disease, Nanjing Medical Association, Nanjing, China
- Reproductive Medicine, Jiangsu Association of Integrative Medicine, Nanjing, Jiangsu, China
| | - Yaping Wang
- Centre for Reproductive Endocrinology and Infertility, Peking Union Medical College Hospital, Peking, China
| | | | - Kyoo Kim
- Abbott Products Operations AG, Basel-Landschaft, Switzerland
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Wang Q, Liu S, Nie Z, Zhu Z, Fu Y, Zhang J, Wei X, Yang L, Wei X. The pan-Canadian Tiered Pricing Framework and Chinese National Volume-Based Procurement: A comparative study using Donabedian's structure-process-outcome framework. J Glob Health 2023; 13:04137. [PMID: 37947028 PMCID: PMC10636597 DOI: 10.7189/jogh.13.04137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Background Generic drugs have been seen as a potentially powerful way to alleviate the financial burden on patients and health care systems. Two strategies for achieving rational prices of generic drugs are tiered pricing framework and pooled purchasing power. We compare the pan-Canadian Tiered Pricing Framework (TPF) and the Chinese National Volume-Based Procurement (NVBP) as comparators to explore the similarities and differences between the two mechanisms and summarise lessons for other jurisdictions. Methods This comparative study applies Donabedian's structure-process-outcome framework to systematically analyse the macro contexts, procedures, and long- and short-term results of each pricing mechanism, and the interactions between them. Results Structure: TPF is an upstream initiative aimed at lowering the prices of generic drugs and increasing coverage and price consistency. NVBP is a downstream national initiative prioritised for reducing drug prices to achieve value-based purchasing. Process: By associating the number of manufacturers with price cuts, TPF leaves the choice to manufacturers to decide if they want to enter a specific market. In contrast, the Chinese government determines NVBP list and has the authority to choose manufacturer(s) with the lowest price(s). TPF provides clear price information to potential suppliers with unclear order quantity. The NVBP drug price is determined by tendering, while procurement volume is clear and massive. Outcome: The effectiveness of TPF and NVBP is similar, with both achieving a 53% price cut. Both TPF and NVBP experienced efficiency improvement since their establishment, with 98 and 86 drugs priced per year. By comparing 60 drugs covered by both programmes, the NVBP price is 57% of that of the TPF counterpart on average (1.1 to 301.6%), by purchase power parity. Conclusions The tiered pricing scheme is feasible in regions with a stable and mature pharmaceutical market, typically seen in high-income countries, while tendering is more workable in low- and middle-income countries where the pharmaceutical market is weak and unstable. Experience in the two countries shows that a coordinated pricing mechanism involves many piecemeal interactive problems, which a sophisticated system with a robust long-range plan may address better.
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Affiliation(s)
- Quan Wang
- School of Public Health, Peking University, Beijing, China
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Siqi Liu
- Center of Health System and Policy, Institute of Medical Information & Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Zhijie Nie
- School of Public Health, Peking University, Beijing, China
| | - Zheng Zhu
- School of Public Health, Peking University, Beijing, China
| | - Yaqun Fu
- School of Public Health, Peking University, Beijing, China
| | - Jiawei Zhang
- School of Public Health, Peking University, Beijing, China
| | - Xia Wei
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, England, UK
| | - Li Yang
- School of Public Health, Peking University, Beijing, China
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Xia Y, Lian D, Yang Y, Si L, Ming J, Wei Y, Chen Y. The quality of published health economic evaluations on screening programs in China: a systematic review and quantitative appraisal. Expert Rev Pharmacoecon Outcomes Res 2022; 22:1277-1283. [PMID: 36226906 DOI: 10.1080/14737167.2022.2131542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study seeks to assess the quality of HEEs reporting on screening programs over the last 20 years in China, to identify potential predictors of reporting quality. METHODS We performed a literature search of HEE studies published in PubMed, Embase, CNKI, and WANFANG from 2000 to 2021. The search terms included 'screening,' 'China,' 'CEA,' 'CBA,' 'CUA,' and all other names for health economic evaluation. Two reviewers independently extracted data and assessed the reporting quality using CHEERS checklist. A generalized linear regression analysis was used to identify the predictors of reporting quality. RESULTS 133 of 1,281 identified studies was included. The reporting quality scores showed an increasing trend and the mean score was 0.56. Some items were underreported, such as study perspective, discount rate, measurement of effectiveness, analytical methods, uncertainty, heterogeneity etc. Five factors (year of publication, journal type, first author's affiliation, economic evaluation type, specialty journals or not) predicted a higher score of reporting quality in the regression analyses (P < 0.05). CONCLUSIONS Overall, the quality of HEEs on screening programs in China showed an improving trend. Given the significance of reporting quality, it is advisable to report HEE results following standard evaluation guidelines to improve their transparency.
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Affiliation(s)
- Yu Xia
- School of Public Health, Fudan University, Shanghai, China.,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Dai Lian
- School of Public Health, Fudan University, Shanghai, China.,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yi Yang
- School of Public Health, Fudan University, Shanghai, China.,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Lei Si
- School of Health Sciences, Western Sydney University, Campbelltown, Australia.,The George Institute for Global Health, UNSW Sydney, Kensingto, Australia
| | - Jian Ming
- School of Public Health, Fudan University, Shanghai, China.,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yan Wei
- School of Public Health, Fudan University, Shanghai, China.,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yingyao Chen
- School of Public Health, Fudan University, Shanghai, China.,National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
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Shi Y, Song H, Liu J, Lin J, Fang L. Comprehensive Evaluation of Clinical Application of Balanced Compound Amino Acid Injection. Front Nutr 2022; 9:880256. [PMID: 35719164 PMCID: PMC9203120 DOI: 10.3389/fnut.2022.880256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 05/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background To provide a reference for hospital drug selection and rational clinical drug selection based on the evaluation of the safety, nutritional quality, and economy of 27 manufacturers of five varieties (18AA, 18AA-I, 18AA-II, 18AA-IV, 18AA-V) of balanced compound amino acids for injection and (18AA-IIoriginal research). Methods The safety of compound amino acids for injection was evaluated by comparing the antioxidant sulfite contents. Based on the amino acid scoring standard mode and the whole egg protein mode as proposed by the Food and Agriculture Organization of the United Nations/World Health Organization (FAO/WHO) in 1973, we compared the formula. The first limiting amino acid content and the comprehensive quality of the total essential amino acid (EAA) contents of the six formulations were studied. The price/content ratio was used to evaluate their economy. Results Similar variety produced by different manufacturers have the same formula and contents of balanced compound amino acids for injection. Safety: 18AA-IIoriginal research and 18AA-II had the lowest sulfite content. Compared with 18AA-IIoriginal research, the sulfite content of 18AA-I, 18AA, 18AA-V, and 18AA-IV were higher (10 times, 16.67 times, 16.67 times, and 33.33 times, respectively). The lower the sulfite content, the safer the product. Nutritional quality: The proportions of amino acids in the five varieties of compound amino acid injection were all suitable. The order of the first limiting amino acids for the formulations was 18AA-IIoriginal research = 18AA-II>18AA >18AA-I = 18AA-IV>18AA-V. The order of the EAA values for the formulations was 18AA-IIoriginal research = 18AA-II>18AA>18AA-I > 18AA-IV > 18AA-V. The overall effectiveness order was 18AA-IIoriginal research = 18AA-II>18AA > 18AA-I>18AA-IV>18AA-V. Economy: Among the 27 manufacturers, 12 manufacturers had a price/content ratio higher than that of 18AA-II original research manufacturers, and 15 manufacturers had a price/content ratio lower than original research manufacturers. Conclusion Through its security, effectiveness, and economy of the comprehensive research, we recommended 18AA-II and 18AA-IIoriginal research with high safety, efficacy, and reasonable price as the first choice. 18AA and 18AA-I with better safety and reasonable price, secondary recommendation. 18AA-IV or 18AA-V with poor safety, efficacy, and economy are not recommended.
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Affiliation(s)
- Yingqin Shi
- Department of Pharmacy, Hebei General Hospital, Shijiazhuang, China
- *Correspondence: Yingqin Shi,
| | - Hai Song
- Department of Science and Education, Tangshan People’s Hospital, Tangshan, China
| | - Jinyan Liu
- Department of Pharmacy, The Second Hospital of Tangshan, Tangshan, China
| | - Jie Lin
- Department of Pharmacy, Hebei General Hospital, Shijiazhuang, China
| | - Lingzhi Fang
- Department of Pharmacy, Hebei General Hospital, Shijiazhuang, China
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Cai D, Shi S, Jiang S, Si L, Wu J, Jiang Y. Estimation of the cost-effective threshold of a quality-adjusted life year in China based on the value of statistical life. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:607-615. [PMID: 34655364 PMCID: PMC9135816 DOI: 10.1007/s10198-021-01384-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/28/2021] [Indexed: 05/19/2023]
Abstract
Cost-effective threshold (CET) is essential for health technology assessment and decision-making based on health economic evaluations. Recently, it has been argued that the commonly used once and three times of gross domestic product (GDP) per capita CETs of a quality-adjusted life year (QALY) are not necessarily empirically supported in all countries. Therefore, we aimed to estimate the CET of a QALY as times of GDP per capita in China, of which the reimbursement coverage decisions are increasingly engaging economic evaluations. Estimates on the value of statistical life (VSL) in China were identified from several studies in the literature and converted to times of GDP per capita, the weighted average of which was used for subsequent calculation. By pooling data on population mortality, health utility, and age distribution, we estimated the value of a statistical QALY (VSQ) from VSL using an established mathematical process, which represented the theoretical upper bound of CET. The corresponding point estimate and theoretical lower bound were obtained using their numerical relationships with the upper bound. Scenarios analyses were also conducted. The estimated CET, its upper bound, and its lower bound were 1.45, 2.90, and 1.16 times of GDP per capita in China, respectively. In different scenarios, the estimated CET varied but was greater than once GDP per capita in most cases. As such, the CET of a QALY in China is close to 1.5 times of GDP per capita, which should be benchmarked for future ICER-based coverage decisions.
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Affiliation(s)
- Dan Cai
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Si Shi
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Shan Jiang
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Lei Si
- The George Institute for Global Health, UNSW Sydney, Kensington, Australia
- School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin, China.
| | - Yawen Jiang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China.
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Kannenberg A, Seidinger S. Health Economics in the Field of Prosthetics and Orthotics: A Global Perspective. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 2021; 4:35298. [PMID: 37615010 PMCID: PMC10443514 DOI: 10.33137/cpoj.v4i2.35298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The rapid advancement of prosthetic and orthotic (P&O) technology raises the question how the industry can ensure that patients have access to the benefits and providers get paid properly and fairly by healthcare payers. This is a challenge that not only P&O but all areas of health technology face. In many areas of medicine and health products, such as drugs and medical devices, health-technology assessments (HTA) have become a standard procedure in the coverage and reimbursement process. In most countries, P&O is lagging behind that development, although some countries have already formalized HTA for prosthetic and orthotic products and may even use cost-effectiveness analyses to determine pricing and payment amounts. This article gives an overview on the coverage and reimbursement processes in the United States, Canada, Germany, France, Sweden, the United Kingdom, Poland, Japan, and China. This selection reflects the variety and diversity of coverage and reimbursement processes that the P&O industry faces globally. The paper continues with an overview on the necessary research and investment efforts that manufacturers will have to make in the future, and contemplates the likely consequences for the manufacturer community in the market place. Health economics may help support the transition from price-based to value-based coverage and reimbursement but will come at considerable costs to the industry.
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Tong G, Geng Q, Xu T, Wang D, Liu T. Smartphone and web-based independent consultation and feedback for joint replacement surgeries: a randomized control trial protocol. BMC Med Inform Decis Mak 2021; 21:85. [PMID: 33663460 PMCID: PMC7934418 DOI: 10.1186/s12911-021-01457-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
Background Cost control and usage regulation of medical materials (MMs) are the practical issues that the government pays close attention to. Although it is well established that there is great potential to mobilize doctors and patients in participating MMs-related clinical decisions, few interventions adopt effective measures against specific behavioral deficiencies. This study aims at developing and validating an independent consultation and feedback system (ICFS) for optimizing clinical decisions on the use of MMs for inpatients needing joint replacement surgeries. Methods Development of the research protocol is based on a problem or deficiency list derived on a trans-theoretical framework which incorporates including mainly soft systems-thinking, information asymmetry, crisis-coping, dual delegation and planned behavior. The intervention consists of two main components targeting at patients and doctors respectively. Each of the intervention ingredients is designed to tackle the doctor and patient-side problems with MMs using in joint replacement surgeries. The intervention arm receives 18 months' ICFS intervention program on the basis of the routine medical services; while the control arm, only the routine medical services. Implementation of the intervention is supported by an online platform established and maintained by the Quality Assurance Center for Medical Care in Anhui Province, a smartphone-based application program (APP) and a web-based clinical support system. Discussion The implementation of this study is expected to significantly reduce the deficiencies and moral hazards in decision-making of MMs using through the output of economic, efficient, sustainable and easy-to-promote cooperative intervention programs, thus greatly reducing medical costs and standardizing medical behaviors. Trial registration number ISRCTN10152297.
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Affiliation(s)
- Guixian Tong
- School of Management, Hefei University of Technology, No.193 Tunxi Road, Hefei, People's Republic of China.,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, No.17 Lujiang Road, Hefei, People's Republic of China
| | - Qingqing Geng
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui University of Traditional Chinese Medicine, No.177 Meishan Road, Hefei, People's Republic of China
| | - Tong Xu
- School of Data Science, University of Science and Technology of China, No. 443 Huangshan Road, Hefei, People's Republic of China
| | - Debin Wang
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Hefei, People's Republic of China
| | - Tongzhu Liu
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, No.17 Lujiang Road, Hefei, People's Republic of China.
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10
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The Development of Health Technology Assessment in Asia: Current Status and Future Trends. Value Health Reg Issues 2020; 21:39-44. [DOI: 10.1016/j.vhri.2019.08.472] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/21/2019] [Accepted: 08/10/2019] [Indexed: 01/11/2023]
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Wang H, Jin C, Bai F, Lin X, Fang L, Sun H, Cheng W, Song P. Driving factors and mode transformation regarding health technology assessment (HTA) in China: Problems and recommendations. Biosci Trends 2019; 13:110-116. [PMID: 31006715 DOI: 10.5582/bst.2019.01100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
As the reform of Chinese medical and health undertakings has advanced (since 2015), the admission, pricing and payment policies regarding the new health technologies of China have undergone significant changes, and health technology assessment (HTA) has gradually become one of the current reform and research hotspots in China. Based on the perspective of HTA driving factors and the development mode, this paper proposes a two-stage mode of HTA development in China, namely, the mode driven by the management of new heath technology admission and another one driven by new health technology pricing and medical insurance payment. In addition, the paper also proposes the challenges that HTA faces in China under the current mode, including the development system, process standard, data mechanism, and policy application. Besides, recommendations are provided for the further development of HTA construction in China, including strengthening the development system of regional HTA centers, formulating HTA process guidance, building a database, improving evaluation quality and intensifying policy integration.
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Affiliation(s)
- Haiyin Wang
- Shanghai Health Development Research Center (Shanghai Medical Information Center)
| | - Chunlin Jin
- Shanghai Health Development Research Center (Shanghai Medical Information Center)
| | - Fei Bai
- Medical Administration Center of National Health Commission
| | - Xia Lin
- Medical Administration Center of National Health Commission
| | - Liang Fang
- Shanghai Health Development Research Center (Shanghai Medical Information Center)
| | - Hui Sun
- Shanghai Health Development Research Center (Shanghai Medical Information Center)
| | - Wendi Cheng
- Shanghai Health Development Research Center (Shanghai Medical Information Center)
| | - Peipei Song
- Shanghai Health Development Research Center (Shanghai Medical Information Center).,National Center for Global Health and Medicine
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MacQuilkan K, Baker P, Downey L, Ruiz F, Chalkidou K, Prinja S, Zhao K, Wilkinson T, Glassman A, Hofman K. Strengthening health technology assessment systems in the global south: a comparative analysis of the HTA journeys of China, India and South Africa. Glob Health Action 2018; 11:1527556. [PMID: 30326795 PMCID: PMC6197020 DOI: 10.1080/16549716.2018.1527556] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/19/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Resource allocation in health is universally challenging, but especially so in resource-constrained contexts in the Global South. Pursuing a strategy of evidence-based decision-making and using tools such as Health Technology Assessment (HTA), can help address issues relating to both affordability and equity when allocating resources. Three BRICS and Global South countries, China, India and South Africa have committed to strengthening HTA capacity and developing their domestic HTA systems, with the goal of getting evidence translated into policy. Through assessing and comparing the HTA journey of each country it may be possible to identify common problems and shareable insights. OBJECTIVES This collaborative paper aimed to share knowledge on strengthening HTA systems to enable enhanced evidence-based decision-making in the Global South by: Identifying common barriers and enablers in three BRICS countries in the Global South; and Exploring how South-South collaboration can strengthen HTA capacity and utilisation for better healthcare decision-making. METHODS A descriptive and explorative comparative analysis was conducted comprising a Within-Case analysis to produce a narrative of the HTA journey in each country and an Across-Case analysis to explore both knowledge that could be shared and any potential knowledge gaps. RESULTS Analyses revealed that China, India and South Africa share many barriers to strengthening and developing HTA systems such as: (1) Minimal HTA expertise; (2) Weak health data infrastructure; (3) Rising healthcare costs; (4) Fragmented healthcare systems; and (5) Significant growth in non-communicable diseases. Stakeholder engagement and institutionalisation of HTA were identified as two conducive factors for strengthening HTA systems. CONCLUSION China, India and South Africa have all committed to establishing robust HTA systems to inform evidence-based priority setting and have experienced similar challenges. Engagement among countries of the Global South can provide a supportive platform to share knowledge that is more applicable and pragmatic.
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Affiliation(s)
- Kim MacQuilkan
- Priority Cost Effective Lessons for System Strengthening South Africa (PRICELESS SA), Faculty of Health Sciences, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Peter Baker
- Global Health and Development Group, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Laura Downey
- Global Health and Development Group, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Francis Ruiz
- Global Health and Development Group, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Kalipso Chalkidou
- Global Health and Development Group, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Shankar Prinja
- School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kun Zhao
- Division of Health Technology Assessment and Policy Evaluation, China National Health Development Research Center (CHNHDR), Ministry of Health, Beijing, China
| | - Thomas Wilkinson
- Priority Cost Effective Lessons for System Strengthening South Africa (PRICELESS SA), Faculty of Health Sciences, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | | | - Karen Hofman
- Priority Cost Effective Lessons for System Strengthening South Africa (PRICELESS SA), Faculty of Health Sciences, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
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