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Goudarzi Z, Marzaleh MA, Nikfar S, Kebriaeezadeh A, Zenouz RY, Abdollahiasl A, Nouhi M. Towards greater impact in health technology assessment: System dynamic approach for new and emerging technologies in Iran. Daru 2024; 32:25-45. [PMID: 37917419 PMCID: PMC11087392 DOI: 10.1007/s40199-023-00483-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/17/2023] [Indexed: 11/04/2023] Open
Abstract
PURPOSE As classical health technology assessment models fail to predict the complexities of related impacts, the application of modeling techniques such as systems dynamics simulation (SD) is essential. This study aimed to develop an SD model to predict the outcomes of access to a new medicine in Iran. METHODS This study extracted the important and influential variables in providing access to new pharmaceutical technologies by comprehensively reviewing previous research and combining the technical knowledge of experts in this field. The variables were incorporated into the systems thinking framework and modeled using dynamic systems tools, followed by simulation and testing in VENSIM. The model was piloted for deferoxamine and deferasirox in thalassemia. Various tests were used to evaluate the validity and reliability of the model. The model was designed for a ten-year horizon (2018-2028) for medicines selected as the pilot. RESULTS The variables extracted from the panel of experts encompassed the primary and short-term impacts of access to newly emerged medicine and long-term impacts regarding the economy, health, and society. After modeling, the leverage points presented for the problem with the greatest impact or effectiveness in access to new medicine included the policy determining the amount of medicine supply, the import and production of medicine, the prevalence and incidence of disease, insurance coverage, and treatment adherence. CONCLUSION The SD models allow the researchers to evaluate the efficiency and health outcomes of a new pharmaceutical more precisely in the health system in Iran.
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Affiliation(s)
- Zahra Goudarzi
- Faculty of Medical Information and Management, Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Qasr Al-Dasht St., 27 Alley, Shiraz, 7133654361, Iran
| | - Milad Ahmadi Marzaleh
- Department of Health in Disasters and Emergencies, Faculty of Medical Information and Management, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Qasr Al-Dasht St., 27 Alley, Shiraz, 7133654361, Iran
| | - Shekoufeh Nikfar
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Enghelab Square,16 Azar St., Tehran, 1417614411, Iran
| | - Abbas Kebriaeezadeh
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Enghelab Square,16 Azar St., Tehran, 1417614411, Iran
| | - Reza Yousefi Zenouz
- Department of Operations and Information Technology Management, Faculty of Management, Kharazmi University, Tehran Between Shahid Qorani and Ostad Nejatollahi, Somia St, No 242, Tehran, 159996415, Iran
| | - Akbar Abdollahiasl
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Enghelab Square,16 Azar St., Tehran, 1417614411, Iran.
| | - Mojtaba Nouhi
- National Institute for Health Research, Tehran University of Medical Sciences, Keshahvarz Blvd, Vasal Shirazi Street, Bozorgmehr East Street, Number 70, Tehran, 62921000, Iran
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Yang J, Yu HJ. [Practices and reflections on lecturing of vaccinology in general education towards undergraduate students: from the perspective of Comprehensive Health and New Medicine]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:1165-8. [PMID: 33115206 DOI: 10.3760/cma.j.cn112150-20200624-00925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Multiple and cross disciplinary education among medical sciences and other subjects have been much emphasized in the context of new medicine, which generate higher standards of general medical education practice. The department of epidemiology, school of public health, Fudan university, offer lectures of vaccinology towards undergraduate students in general education. This article introduces the course objectives, content, selection of teaching materials, teaching methods as well as primary output since the Autumn semester in 2018. In addition, this article proposes ideas of course improvement in the context of responses to COVID-19 pandemic. The teaching exploration could provide reference for related universities on medical and public health education from the perspective of comprehensive health.
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Liu Y, Jin GF, Wang JM, Xia YK, Shen HB, Wang CQ, Hu ZB. [Thoughts on the reform of preventive medicine education in the context of new medicine]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:593-596. [PMID: 32253890 DOI: 10.3760/cma.j.cn112150-20200328-00461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Talent training is the core and foundation of public health system construction. Shortage of talents in the field of disease prevention and public health exposed by COVID-19 pandemic highlights the importance of developing preventive medical education. This article analyzes the challenges of medical education in the dilemma of "separation of medical treatment and prevention", and the new requirements for preventive medical education in the construction of New Medicine under the Healthy China strategy. Four aspects including stepping up the resource allocation and investment, educating responsible public health professionals, the education of all medical students who implement the core competence of public health, and the establishment of a continuing education system for preventive medicine have been considered. A series of specific suggestions are put forward including the establishment of a full-chain closed-loop research system to support the cultivation of top-notch innovative public health talents, strengthening the assessment of core public health capabilities for clinical medical professional admission, formulating a "medical and preventive integration" training program for primary health personnel, and implementing "combination of peace and war" public health personnel reserve system, with the purpose of providing reference for the reform and development of preventive medical education in China.
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Affiliation(s)
- Y Liu
- Medical Education Institution, Nanjing Medical University, Nanjing 211166, China
| | - G F Jin
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - J M Wang
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Y K Xia
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - H B Shen
- Nanjing Medical University, Nanjing 211166, China
| | - C Q Wang
- Nanjing Medical University, Nanjing 211166, China
| | - Z B Hu
- Nanjing Medical University, Nanjing 211166, China
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Vitry AI, Shin NH, Vitre P. Assessment of the therapeutic value of new medicines marketed in Australia. J Pharm Policy Pract 2013; 6:2. [PMID: 24764537 PMCID: PMC3987060 DOI: 10.1186/2052-3211-6-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 04/26/2013] [Indexed: 11/24/2022] Open
Abstract
Background The belief that all new medicines bring a therapeutic innovation and better health outcomes is widely shared among the public, health professionals and policy makers. Objectives To examine the therapeutic value of new medicines marketed in Australia using two classification systems. Methods The therapeutic value of new medicines was categorised using the Motola’s s and the Ahlqvist-Rastad’s systems for all approvals made by the Australian Therapeutics Goods Administration (TGA) between 2005 and 2007. Scores were assigned independently by the three authors on the basis of the Public Summary Documents and Prescrire’ review articles. Results Overall, 217 approval recommendations were made including 81 (37.3%) for new indications and 69 (31.8%) for new medicines. In Motola’s rating system, 31 (52.5%) of the 59 drugs were rated as pharmacological or technological innovations and 28 (47.5%) were rated as therapeutic innovations. Only seven of the 59 drugs (11.9%) were rated as important innovations. In Ahlqvist-Rastad’s system, only a third of the new drugs were rated as “added therapeutic value”. Conclusion Only a minority of the new medicines marketed in Australia provide added therapeutic value compared to existing treatments. Stricter regulatory approval criteria would ensure better safety of the public and simplify the reimbursement processes.
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Affiliation(s)
- Agnes I Vitry
- Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Sciences, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Ng Huah Shin
- Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Sciences, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Pauline Vitre
- Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Sciences, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
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