Informing a Cost-Effectiveness Threshold for Health Technology Assessment in China: A Marginal Productivity Approach.

Abstract:

BACKGROUND:Health technology assessment has been increasingly used in China, having been legally mandated in 2019, to inform reimbursement decisions and price negotiations between the National Healthcare Security Administration and pharmaceutical companies around the price of new pharmaceuticals. The criteria currently used to judge cost effectiveness and inform pricing negotiations, 3 × GDP per capita, is based on the rule of thumb previously recommended by the World Health Organization rather than an estimate based on an empirical assessment of health opportunity costs. OBJECTIVE:The objective of this study was to inform a cost-effectiveness threshold for health technology assessment in China that accounts for health opportunity cost. METHODS:The elasticity of health outcomes with respect to health expenditure was estimated using variations across 30 provincial-level administrative divisions in 2017 controlling for a range of other factors and using an instrumental variable approach to account for endogeneity to assess robustness of results. The estimated elasticity was then used to calculate the cost per disability-adjusted life-year (DALY) averted by variations in Chinese health expenditure at the margin. RESULTS:The range estimated from this study, 27,923-52,247 (2017 RMB) (central estimate 37,446) per DALY averted or 47-88% of GDP per capita (central estimate 63%), shows that a cost per DALY averted cost-effectiveness threshold that reflects health opportunity costs is below 1 × GDP per capita. CONCLUSION:Our results suggest that the current cost-effectiveness threshold used in China is too high; continuing to use it risks decisions that reduce overall population health.

journal_name

Pharmacoeconomics

journal_title

PharmacoEconomics

authors

Ochalek J,Wang H,Gu Y,Lomas J,Cutler H,Jin C

doi

10.1007/s40273-020-00954-y

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

1319-1331

issue

12

eissn

1170-7690

issn

1179-2027

pii

10.1007/s40273-020-00954-y

journal_volume

38

pub_type

杂志文章
  • Clinical aspects of therapeutic substitution.

    abstract::A variety of problems are associated with the operation, quality, costs, and benefits of therapeutic substitution programmes. Adequate communication of procedures, events, and failures are essential features of a safe therapeutic substitution policy. However, case reports of suboptimal therapy and differences in pha...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199200011-00010

    authors: Levy RA

    更新日期:1992-01-01 00:00:00

  • A model to compute the medical cost of patients in intensive care.

    abstract:OBJECTIVE:Our objective was to identify, among the information routinely collected on patients in intensive care units (ICUs), data that determine the total cost for a given patient. DESIGN:We developed a model that could help physicians in medical ICUs to estimate the cost of care for their patients when no cost data...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2165/00019053-199915060-00005

    authors: Chaix C,Durand-Zaleski I,Alberti C,Brun-Buisson C

    更新日期:1999-06-01 00:00:00

  • The value of thinly spread QALYs.

    abstract::A number of recent findings from the literature imply that the value of a QALY varies depending on the concentration or dispersion of that QALY over treated individuals. Given that funding decisions are currently made under either the assumption of distributive-neutrality or some combination of explicit decision crite...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200624090-00003

    authors: Mortimer D

    更新日期:2006-01-01 00:00:00

  • A Markov process analysis comparing the cost effectiveness of maintenance therapy with citalopram versus standard therapy in major depression.

    abstract::The objective of this study was to demonstrate the cost effectiveness of long term maintenance treatment with citalopram versus standard therapy (defined as short term antidepressant treatment) in patients with major depression in Germany. We chose doxepin, amitriptyline and trimipramine as standard therapy because th...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199508020-00007

    authors: Nuijten MJ,Hardens M,Souêtre E

    更新日期:1995-08-01 00:00:00

  • Concepts of 'personalization' in personalized medicine: implications for economic evaluation.

    abstract:CONTEXT:This study assesses if, and how, existing methods for economic evaluation are applicable to the evaluation of personalized medicine (PM) and, if not, where extension to methods may be required. METHODS:A structured workshop was held with a predefined group of experts (n = 47), and was run using a modified nomi...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-014-0211-5

    authors: Rogowski W,Payne K,Schnell-Inderst P,Manca A,Rochau U,Jahn B,Alagoz O,Leidl R,Siebert U

    更新日期:2015-01-01 00:00:00

  • A Practical Guide to Conducting a Systematic Review and Meta-analysis of Health State Utility Values.

    abstract::Economic analysts are increasingly likely to rely on systematic reviews and meta-analyses of health state utility values to inform the parameter inputs of decision-analytic modelling-based economic evaluations. Beyond the context of economic evaluation, evidence from systematic reviews and meta-analyses of health stat...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-018-0670-1

    authors: Petrou S,Kwon J,Madan J

    更新日期:2018-09-01 00:00:00

  • Cost effectiveness of adding ezetimibe to atorvastatin therapy in patients not at cholesterol treatment goal in Canada.

    abstract:INTRODUCTION:This analysis compared the cost effectiveness of adding ezetimibe to atorvastatin therapy versus atorvastatin titration or adding cholestyramine (a resin) for patients at high risk of a coronary artery disease (CAD) event who did not reach target cholesterol levels on their current atorvastatin dosage. The...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200624080-00007

    authors: Kohli M,Attard C,Lam A,Huse D,Cook J,Bourgault C,Alemao E,Yin D,Marentette M

    更新日期:2006-01-01 00:00:00

  • Changing therapeutic regimens in benign prostatic hyperplasia. Clinical and economic considerations.

    abstract::About one-quarter of men aged 50 years and older experience voiding problems due to benign prostatic hyperplasia (BPH). Until about 10 years ago, surgery (particularly transurethral resection of the prostate) was the only effective treatment for symptomatic BPH. Over the last decade, several new treatments have been i...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200119020-00003

    authors: Stoevelaar HJ,McDonnell J

    更新日期:2001-01-01 00:00:00

  • Evaluation of the pharmacoeconomic literature.

    abstract::Pharmacoeconomics identifies, measures, and compares the costs and consequences of pharmaceutical products and services. The cost effectiveness of a pharmacotherapy in a particular indication depends on the molecular configuration of the drug, its safety and efficacy, and local market factors such as the acquisition ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199406040-00002

    authors: Milne RJ

    更新日期:1994-10-01 00:00:00

  • Economic Analysis of First-Line Treatment with Cetuximab or Panitumumab for RAS Wild-Type Metastatic Colorectal Cancer in England.

    abstract:BACKGROUND:Combination therapies with cetuximab (Erbitux®; Merck Serono UK Ltd) and panitumumab (Vectibix®; Amgen UK Ltd) are shown to be less effective in adults with metastatic colorectal cancer who have mutations in exons 2, 3 and 4 of KRAS and NRAS oncogenes from the rat sarcoma (RAS) family. OBJECTIVE:The objecti...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-018-0630-9

    authors: Tikhonova IA,Huxley N,Snowsill T,Crathorne L,Varley-Campbell J,Napier M,Hoyle M

    更新日期:2018-07-01 00:00:00

  • Cost-Effectiveness of an Individualized First-Line Treatment Strategy Offering Erlotinib Based on EGFR Mutation Testing in Advanced Lung Adenocarcinoma Patients in Germany.

    abstract:BACKGROUND:Lung cancer is among the top causes of cancer-related deaths. Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors can increase progression-free survival compared with standard chemotherapy in patients with EGFR mutation-positive advanced non-small cell lung cancer (NSCLC). OBJECTIVE:The aim o...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-015-0305-8

    authors: Schremser K,Rogowski WH,Adler-Reichel S,Tufman AL,Huber RM,Stollenwerk B

    更新日期:2015-11-01 00:00:00

  • Clinical and economic factors important to anaesthetic choice for day-case surgery.

    abstract::Clinical and economic factors that are important to consider when selecting anaesthesia for day-case surgery can differ from those for inpatient anaesthesia. Patients undergoing day-case surgery tend to be healthier and have shorter durations of surgery. They expect less anxiety before surgery, amnesia for the surgica...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200017030-00003

    authors: Eger EI,White PF,Bogetz MS

    更新日期:2000-03-01 00:00:00

  • Comparing the Analysis and Results of a Modified Social Accounting Matrix Framework with Conventional Methods of Reporting Indirect Non-Medical Costs.

    abstract:BACKGROUND:Assessing the societal perspective in economic evaluations of new interventions requires estimates of indirect non-medical costs caused by the disease. Different methods exist for measuring the labor input function as a surrogate for these costs. They rarely specify the effect of health on labor and who gain...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-020-00978-4

    authors: Standaert B,Sauboin C,Leclerc QJ,Connolly MP

    更新日期:2020-11-25 00:00:00

  • Assessment of Health Economics in Alzheimer's Disease (AHEAD): treatment with galantamine in Sweden.

    abstract:BACKGROUND:Like other developed countries with aging populations, Sweden is expecting large increases in the prevalence of Alzheimer's disease and corresponding escalations in the cost of care for patients with this disease. Galantamine, a new acetylcholinesterase inhibitor and nicotinic modulator, has proved effective...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200220090-00006

    authors: Garfield FB,Getsios D,Caro JJ,Wimo A,Winblad B

    更新日期:2002-01-01 00:00:00

  • On individual preferences and aggregation in economic evaluation in healthcare.

    abstract::For practical reasons, in order to carry out economic evaluations of collective decisions, total costs will generally be compared with total benefits; hence, individuals' willingness to pay (WTP) or quality-adjusted life-years (QALYs) have to be estimated at an aggregate level. So far, aggregation has usually been don...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200119040-00001

    authors: Liljas B,Lindgren B

    更新日期:2001-01-01 00:00:00

  • Cost Effectiveness of Alectinib vs. Crizotinib in First-Line Anaplastic Lymphoma Kinase-Positive Advanced Non-Small-Cell Lung Cancer.

    abstract:BACKGROUND:The recently completed ALEX trial demonstrated that alectinib improved progression-free survival, and delayed time to central nervous system progression compared with crizotinib in patients with anaplastic lymphoma kinase-positive non-small-cell lung cancer. However, the long-term clinical and economic impac...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-018-0625-6

    authors: Carlson JJ,Suh K,Orfanos P,Wong W

    更新日期:2018-04-01 00:00:00

  • Costs of deep foot infections in patients with diabetes mellitus.

    abstract:OBJECTIVE:To calculate costs for the management of deep foot infections and to identify the most important factors related to treatment costs. DESIGN:Costs for in-hospital care, surgery, investigations, antibacterials, visits to the foot-care team, orthopaedic appliances and topical treatment were calculated retrospec...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200018030-00003

    authors: Tennvall GR,Apelqvist J,Eneroth M

    更新日期:2000-09-01 00:00:00

  • Long-acting risperidone compared with oral olanzapine and haloperidol depot in schizophrenia: a Belgian cost-effectiveness analysis.

    abstract::Patients with schizophrenia suffer numerous relapses and rehospitalizations that are associated with high direct and indirect medical expense. Suboptimal therapeutic efficacy and, in particular, problems with compliance are major factors leading to relapse. Atypical antipsychotic agents offer improved efficacy and a l...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200523001-00004

    authors: De Graeve D,Smet A,Mehnert A,Caleo S,Miadi-Fargier H,Mosqueda GJ,Lecompte D,Peuskens J

    更新日期:2005-01-01 00:00:00

  • Refitting of the UKPDS 68 risk equations to contemporary routine clinical practice data in the UK.

    abstract:OBJECTIVE:Economic evaluations of new diabetes therapies rely heavily upon the UK Prospective Diabetes Study (UKPDS) equations for prediction of cardiovascular events; however, concerns persist regarding their relevance to current clinical practice and appropriate use in populations other than newly diagnosed patients....

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-014-0225-z

    authors: McEwan P,Bennett H,Ward T,Bergenheim K

    更新日期:2015-02-01 00:00:00

  • Cost-utility analysis of varenicline versus existing smoking cessation strategies using the BENESCO Simulation model: application to a population of US adult smokers.

    abstract:BACKGROUND:Of 1 346 700 total deaths each year in the US, an estimated 440 100 are smoking related, making it the leading preventable cause of premature death in the US. Despite the health and economic benefits of smoking cessation being well documented, reimbursement coverage for smoking cessation therapies is general...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200826060-00004

    authors: Howard P,Knight C,Boler A,Baker C

    更新日期:2008-01-01 00:00:00

  • Economic evaluation of a new acellular vaccine for pertussis in Canada.

    abstract:OBJECTIVE:Pertussis is a highly contagious infection affecting mainly children. Acellular pertussis vaccines were recently introduced in Canada based on evidence of improved safety and efficacy over whole cell vaccines, the current standard of care. The following study reports the economic impact of replacing the whole...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200119050-00009

    authors: Iskedjian M,Einarson TR,O'Brien BJ,De Serres JG,Gold R,Gemmill IM,Milkovich N,Rosner A

    更新日期:2001-01-01 00:00:00

  • Pharmacoeconomic considerations in treating patients with acute leukaemia.

    abstract::Whereas individual cost-effectiveness analyses of new agents for acute leukaemia should be performed in target populations, any meaningful pharmacoeconomic evaluation of treatment options for this condition should include the many types of costs and outcomes in unselected, representative groups of patients. Both direc...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199915020-00005

    authors: Jønsson V,Hansen MM,Ljungman P,Kaasa S

    更新日期:1999-02-01 00:00:00

  • The Monetary Value of Informal Care: Obtaining Pure Time Valuations Using a Discrete Choice Experiment.

    abstract:BACKGROUND:Interventions in health care often not only have an effect on patients, but also on their informal caregivers. Caregiving can have a profound impact on the health and wellbeing of carers. Ignoring these spillovers in economic evaluations risks labelling interventions mistakenly as cost-effective, at the expe...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-018-0724-4

    authors: Hoefman RJ,van Exel J,Brouwer WBF

    更新日期:2019-04-01 00:00:00

  • Predicting direct costs of HIV care during the first year of darunavir-based highly active antiretroviral therapy using CD4 cell counts: evidence from POWER.

    abstract:BACKGROUND:Given the association between CD4 cell counts and HIV-related morbidity/mortality, new antiretroviral therapies could potentially lower the direct costs of HIV care by raising CD4 cell counts. OBJECTIVES:To predict the effects of the ritonavir-boosted, HIV protease inhibitor (PI) darunavir on the direct cos...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/11587510-000000000-00000

    authors: Hill AM,Gebo K,Hemmett L,Löthgren M,Allegri G,Smets E

    更新日期:2010-01-01 00:00:00

  • Rufinamide: a pharmacoeconomic profile of its use as adjunctive therapy in Lennox-Gastaut syndrome.

    abstract::Rufinamide (Inovelon®), a triazole derivative, is an oral antiepileptic drug approved in the EU as adjunctive therapy in the treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients aged ≥4 years. The efficacy of oral rufinamide as adjunctive therapy in patients with LGS uncontrolled on one to t...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/11208630-000000000-00000

    authors: McCormack PL

    更新日期:2012-03-01 00:00:00

  • Enoxaparin: a pharmacoeconomic review of its use in the prevention and treatment of venous thromboembolism and in acute coronary syndromes.

    abstract::The pharmacoeconomics of the low molecular weight heparin (LMWH) enoxaparin in the prophylaxis and treatment of venous thromboembolism have mostly been investigated in cost-effectiveness studies that estimated direct costs associated with treatment, using decision analyses and clinical outcome data from randomised con...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200220040-00002

    authors: Bergqvist D

    更新日期:2002-01-01 00:00:00

  • Follow-up lipid tests and physician visits are associated with improved adherence to statin therapy.

    abstract:INTRODUCTION AND OBJECTIVE:The National Cholesterol Education Program recommends regular physician follow-up and lipid testing to promote adherence with lipid-lowering medications. The objective of this study was to determine whether lipid tests and physician visits after treatment initiation are indeed associated with...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00019053-200422003-00003

    authors: Benner JS,Tierce JC,Ballantyne CM,Prasad C,Bullano MF,Willey VJ,Erbey J,Sugano DS

    更新日期:2004-01-01 00:00:00

  • Formulary management of ACE inhibitors.

    abstract::An increasing number of ACE inhibitors have become available in recent years. Because these agents are all similar, careful scrutiny is required in order to determine specific advantages of particular agents when making formulary decisions. Differences between agents with regard to structure and tissue specificity hav...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199610060-00006

    authors: Gerbrandt KR,Yedinak KC

    更新日期:1996-12-01 00:00:00

  • Cost effectiveness of fluvoxamine in the treatment of recurrent depression in France.

    abstract:OBJECTIVE:The objective of this study was to examine the cost effectiveness of fluvoxamine compared with tricyclic antidepressants (TCAs) in the treatment of patients with depressive episodes. DESIGN AND SETTING:A Markov process model was constructed to model the effectiveness, as measured by time without depression, ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199814040-00009

    authors: Nuijten M,Hadjadjeba L,Evans C,van den Berg J

    更新日期:1998-10-01 00:00:00

  • The role of pharmacoepidemiology and pharmacoeconomics in promoting access and stimulating innovation.

    abstract::Answering the demanding questions asked of pharmacotherapy in the 21st century will require more reliance on the disciplines of pharmacoepidemiology and pharmacoeconomics. Pharmacoepidemiology can help assess patterns and appropriateness of drug utilisation, provide explanations for poor compliance, quantify the frequ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200422002-00009

    authors: Avorn J

    更新日期:2004-01-01 00:00:00