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Meusel V, Mentzakis E, Baji P, Fiorentini G, Paolucci F. Priority setting in the German healthcare system: results from a discrete choice experiment. Int J Health Econ Manag 2023; 23:411-431. [PMID: 37184821 PMCID: PMC10462569 DOI: 10.1007/s10754-023-09347-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 03/04/2023] [Indexed: 05/16/2023]
Abstract
Worldwide, social healthcare systems must face the challenges of a growing scarcity of resources and of its inevitable distributional effects. Explicit criteria are needed to define the boundaries of public reimbursement decisions. As Germany stands at the beginning of such a discussion, more formalised priority setting procedures seem in order. Recent research identified multi-criteria decision analysis (MCDA) as a promising approach to inform and to guide decision-making in healthcare systems. In that regard, this paper aims to analyse the relative weight assigned to various criteria in setting priority interventions in Germany. A discrete choice experiment (DCE) was employed in 2015 to elicit equity and efficiency preferences of 263 decision makers, through six attributes. The experiment allowed us to rate different policy interventions based on their features in a composite league table (CLT). As number of potential beneficiaries, severity of disease, individual health benefits and cost-effectiveness are the most relevant criteria for German decision makers within the sample population, the results display an overall higher preference towards efficiency criteria. Specific high priority interventions are mental disorders and cardiovascular diseases.
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Affiliation(s)
- V Meusel
- Faculty of Medicine, FAU Erlangen-Nürnberg, Erlangen, Germany.
| | - E Mentzakis
- Department of Economics, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - P Baji
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - G Fiorentini
- Department of Economics, University of Bologna, Bologna, Italy
| | - F Paolucci
- Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Perth, WA, Australia
- Department of Sociology and Law & Economics, University of Bologna, Bologna, Italy
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Rencz F, Gergely L, Wikonkál N, Gáspár K, Péntek M, Gulácsi L, Tamási B, Poór A, Kinyó Á, Bali G, Hidvégi B, Sárdy M, Hajdu K, Szegedi A, Remenyik É, Bata‐Csörgő Z, Holló P, Baji P, Brodszky V. Dermatology Life Quality Index (DLQI) score bands are applicable to DLQI‐Relevant (DLQI‐R) scoring. J Eur Acad Dermatol Venereol 2020; 34:e484-e486. [DOI: 10.1111/jdv.16398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
- Hungarian Academy of Sciences Premium Postdoctoral Research Programme Budapest Hungary
| | - L.H. Gergely
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - N. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Gáspár
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - Á. Kinyó
- Department of Dermatology, Venereology and Oncodermatology University of Pécs Medical School Pécs Hungary
| | - G. Bali
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - B. Hidvégi
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Hajdu
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - A. Szegedi
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Z. Bata‐Csörgő
- Department of Dermatology and Allergology Albert Szent‐Györgyi Medical Centre University of Szeged Szeged Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - P. Baji
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
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Rencz F, Brodszky V, Stalmeier PFM, Tamási B, Kárpáti S, Péntek M, Baji P, Mitev AZ, Gulácsi L. Valuation of pemphigus vulgaris and pemphigus foliaceus health states: a convenience sample experiment. Br J Dermatol 2016; 175:593-9. [PMID: 27062497 DOI: 10.1111/bjd.14647] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) in pemphigus has been widely investigated; nevertheless, utility values for economic evaluations are still lacking. OBJECTIVES To estimate health utilities for hypothetical pemphigus vulgaris (PV) and pemphigus foliaceus (PF) health states in a general population sample. METHODS Three health states (uncontrolled PV, uncontrolled PF and controlled pemphigus) were developed based on a systematic literature review of HRQoL studies in pemphigus. Utilities were obtained from a convenience sample of 108 adults using a visual analogue scale (VAS) and 10-year time trade-off (TTO). Lead-time TTO was applied for health states regarded as worse than dead with a lead time to disease time ratio of 1 : 1. RESULTS The mean VAS utility scores for PV, PF and controlled pemphigus were 0·25 ± 0·15, 0·37 ± 0·17 and 0·63 ± 0·16, respectively. Corresponding TTO utilities were as follows: 0·34 ± 0·38, 0·51 ± 0·32 and 0·75 ± 0·31. Overall, 14% and 6% judged PV and PF as being worse than dead. For both VAS and TTO values, significant differences were observed between all health states (P < 0·001). VAS utilities were rated significantly lower compared with TTO in each health state (P < 0·001). CONCLUSIONS This is the first study that reports health utility values for PV and PF. Successful treatment of pemphigus might result in significant utility gain (0·24-0·41). These empirical findings with respect to three health states in pemphigus may serve as anchor points for further utility studies and cost-effectiveness analyses.
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Affiliation(s)
- F Rencz
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Semmelweis University Doctoral School of Clinical Medicine, Pf. 2, H-1428, Budapest, Hungary
| | - V Brodszky
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.
| | - P F M Stalmeier
- Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - B Tamási
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - M Péntek
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - P Baji
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - A Z Mitev
- Departments of Marketing Research and Consumer Behaviour, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - L Gulácsi
- Departments of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
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Rencz F, Gulácsi L, Péntek M, Wikonkál N, Baji P, Brodszky V. Alopecia areata and health-related quality of life: a systematic review and meta-analysis. Br J Dermatol 2016; 175:561-71. [PMID: 26914830 DOI: 10.1111/bjd.14497] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND No systematic review has yet evaluated the available evidence on health-related quality of life (HRQOL) in alopecia areata (AA). OBJECTIVES To conduct a systematic review and meta-analysis of HRQOL studies among patients diagnosed with AA. METHODS A systematic search was performed for papers published between 1946 and 15 December 2014 in Medline, Embase, Web of Science, CINAHL, PsycINFO and the Cochrane Library. Random-effects meta-analyses were conducted to pool data. RESULTS Twenty-one studies were included, representing a total of 2530 adult patients with AA. Of the 14 different HRQOL measures used in the studies, Dermatology Life Quality Index (DLQI; n = 8) and SF-36 (n = 7) were the most common. Three AA-specific HRQOL instruments were identified: Alopecia Areata Quality of Life Index, Alopecia Areata Quality of Life and Alopecia Areata Symptom Impact Scale. The mean pooled DLQI score of patients with AA was 6·3 (95% confidence interval 5·6-7·1). Comparing age- and sex-matched controls, the meta-analysis of SF-36 studies revealed significantly reduced HRQOL across the role-emotional, mental health and vitality domains (P < 0·001). Wearing a wig had a positive impact, while scalp involvement, anxiety and depression had a negative impact on HRQOL. Conflicting results were found regarding the association between HRQOL and age, sex, marital status and disease duration. CONCLUSIONS Patients with AA experience significant impairment in HRQOL, especially in the area of mental health. Several generic and dermatology-specific HRQOL instruments have been used, but no validation studies have confirmed their applicability in AA. The newly developed AA-specific measures seem very promising; however, a more extensive assessment of validity and reliability is needed.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Doctoral School of Clinical Medicine, Semmelweis University, Pf. 2, H-1428, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - N Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - P Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.
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Rencz F, Gulácsi L, Tamási B, Kárpáti S, Péntek M, Baji P, Brodszky V. Health-related quality of life and its determinants in pemphigus: a systematic review and meta-analysis. Br J Dermatol 2015; 173:1076-80. [DOI: 10.1111/bjd.13848] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- F. Rencz
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
- Semmelweis University Doctoral School of Clinical Medicine; Üllői út 26 H-1085 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology; Semmelweis University; Mária u. 41 H-1085 Budapest Hungary
| | - S. Kárpáti
- Department of Dermatology, Venereology and Dermatooncology; Semmelweis University; Mária u. 41 H-1085 Budapest Hungary
| | - M. Péntek
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
| | - P. Baji
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics; Corvinus University of Budapest; Fővám tér 8 H-1093 Budapest Hungary
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Brodszky V, Strbák B, Baji P, Péntek M, Gulacsi L. Cost-Effectiveness of Fidaxomicin Therapy for Clostridium Difficile Infection in Hungary. Value Health 2014; 17:A675. [PMID: 27202484 DOI: 10.1016/j.jval.2014.08.2505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- V Brodszky
- Corvinus University of Budapest, Budapest, Hungary
| | - B Strbák
- Corvinus University of Budapest, Budapest, Hungary
| | - P Baji
- Corvinus University of Budapest, Budapest, Hungary
| | - M Péntek
- Corvinus University of Budapest, Budapest, Hungary
| | - L Gulacsi
- Corvinus University of Budapest, Budapest, Hungary
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Baji P, Gulacsi L, Strbák B, Péntek M, Brodszky V. Fidaxomicin Therapy for Patients with Clostridium Difficile Infection: A Systematic Literature Review and Meta-Analysis. Value Health 2014; 17:A665. [PMID: 27202426 DOI: 10.1016/j.jval.2014.08.2449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- P Baji
- Corvinus University of Budapest, Budapest, Hungary
| | - L Gulacsi
- Corvinus University of Budapest, Budapest, Hungary
| | - B Strbák
- Corvinus University of Budapest, Budapest, Hungary
| | - M Péntek
- Corvinus University of Budapest, Budapest, Hungary
| | - V Brodszky
- Corvinus University of Budapest, Budapest, Hungary
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Péntek M, Baji P, Pogány G, Brodszky V, Boncz I, Gulácsi L. Health Related Quality of Life of Patients and Their Caregivers In Rare Diseases Results of the Burqol-Rd Project In Hungary. Value Health 2014; 17:A538. [PMID: 27201723 DOI: 10.1016/j.jval.2014.08.1724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- M Péntek
- Corvinus University of Budapest, Budapest, Hungary
| | - P Baji
- Corvinus University of Budapest, Budapest, Hungary
| | - G Pogány
- Hungarian Federation of People with Rare and Congenital Diseases, Budapest, Hungary
| | - V Brodszky
- Corvinus University of Budapest, Budapest, Hungary
| | - I Boncz
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - L Gulácsi
- Corvinus University of Budapest, Budapest, Hungary
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Brodszky V, Gulacsi L, Balogh O, Baji P, Rencz F, Péntek M. Budget Impact Analysis Of Biosimilar Infliximab For The Treatment Of Crohn's Disease In Six Central Eastern European Countries. Value Health 2014; 17:A364. [PMID: 27200752 DOI: 10.1016/j.jval.2014.08.805] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Affiliation(s)
- V Brodszky
- Corvinus University of Budapest, Budapest, Hungary
| | - L Gulacsi
- Corvinus University of Budapest, Budapest, Hungary
| | - O Balogh
- Corvinus University of Budapest, Budapest, Hungary
| | - P Baji
- Corvinus University of Budapest, Budapest, Hungary
| | - F Rencz
- Corvinus University of Budapest, Budapest, Hungary
| | - M Péntek
- Corvinus University of Budapest, Budapest, Hungary
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