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Equity in health services and policy advice for developing countries
Published in Songül Çınaroğlu, Equity and Healthcare Reform in Developing Economies, 2020
In addition to involvement of physicians, other healthcare providers, and professionals in related fields in pharmaceutical design process, rational policymaking will create cost benefits for developing countries (Walt and Gilson, 1994). Health technology assessment, commonly used in developed countries, are essential aspects of healthcare policymaking and must be implemented in developing countries (Awaisu et al., 2018). Rational policymaking in the pharmaceutical market will reduce healthcare inequities and enable effective usage of limited financial resources in developing countries (Hu and Mossialos, 2016). The following section includes specific policy suggestions for improving equity in developing countries.
Health care and cost containment in Denmark
Published in Elias Mossialos, Julian Le Grand, Health Care and Cost Containment in the European Union, 2019
Terkel Christiansen, Ulrika Enemark, Jørgen Clausen, Peter Bo Poulsen
During the 1980s, investment in health care was low, and should now be increased, particularly as much of the equipment is worn out and in need of renewal. Health technology assessment should be used to a greater extent.
Methodological Issues in Health Economic Analysis
Published in Demissie Alemayehu, Joseph C. Cappelleri, Birol Emir, Kelly H. Zou, Statistical Topics in Health Economics and Outcomes Research, 2017
Demissie Alemayehu, Thomas Mathew, Richard J. Willke
Health technology assessment is widely used in many parts of the world to guide decisions regarding the allocation of scarce resources to improve public health. The demands of scarce resources on the health care system and on the patient necessitate the assessment of the relative values of different health care interventions or treatments. Accordingly, several approaches have been proposed to facilitate health economic analysis, including CEA decision analysis. The reliability of results from such analyses, however, is heavily dependent on the validity of the underlying model assumptions, the degree to which the input variables are accurately determined, and the soundness of the theoretical basis for the statistical models. In this chapter, we provided a general overview of the commonly used measures and statistical approaches, with a particular emphasis on measures that need to be taken to mitigate the drawbacks of the approaches.
Indirect treatment comparison (ITC) of the efficacy of vutrisiran and tafamidis for hereditary transthyretin-mediated amyloidosis with polyneuropathy
Published in Expert Opinion on Pharmacotherapy, 2023
Madeline Merkel, David Danese, Chongshu Chen, Jessie Wang, Aozhou Wu, Hongbo Yang, Hollis Lin
ATTRv amyloidosis with polyneuropathy causes potentially irreversible and progressive disability and shortened lifespan. With the growing number of therapeutic options indicated to treat the polyneuropathy of ATTRv amyloidosis, healthcare decision-makers must weigh the effectiveness and safety of each option in order to optimize patients’ clinical outcomes, often without comparative evidence from head-to-head clinical trials. This a priori designed ITC presents compelling evidence that vutrisiran offers greater treatment effects compared to tafamidis on multiple disease-relevant outcomes of ATTRv amyloidosis with polyneuropathy, including sensorimotor neuropathy, HRQOL, and nutritional status. As such, this analysis provides important evidence for future decision-making of health technology assessment agencies, policymakers, clinicians, and other stakeholders.
Safety of drugs used for the treatment of migraine during pregnancy: a narrative review
Published in Expert Review of Clinical Pharmacology, 2023
Jessica A Spiteri, Gabrielle Camilleri, Carlo Piccinni, Janet Sultana
Despite a push in favor to justify clinical trials in pregnant females, they are likely to still be inappropriate for migraine drugs for the reasons discussed. Therefore, the bulk of the evidence will likely remain from observational studies. The use of statistical tools and robust study design will help mitigate the weaknesses of observational studies and hold much promise for the future. Such tools include the propensity score and variations [163]. Such sophisticated methods in addition to more nuanced guidance from regulatory bodies on the kind of evidence that will be required for Health Technology Assessment will help researchers to design targeted studied which use the methods and described the outcomes needed. Such initiatives are spearheaded by entities such as EUnetHTA in Europe.
Health related quality of life in adults with asthma: a systematic review to identify the values of EQ-5D-5L instrument
Published in Journal of Asthma, 2022
Somayeh Afshari, Hosein Ameri, Rajab Ali Daroudi, Maryam Shiravani, Hassan Karami, Ali Akbari Sari
There are a wide range of specific and general instruments for measuring HRQoL in any disease including asthma. It seems that clinicians are more comfortable with using specific instruments compared with general questionnaires. This is perhaps because they assume that the specific instruments might be more valid and reliable. However, using specific instruments significantly limit the ability to compare the effect of healthcare interventions among different diseases. On the other hand, it is very important for policy makers to efficiently allocate limited healthcare resources between different healthcare programs. Health Technology Assessment is a standard technique that is very commonly used for this purpose. Generic instruments like EQ-5D is very helpful for measuring and comparing the HRQoL as a common outcome of different healthcare programs. Crossman et al. (29) have recommend the use of this questionnaire in HTA studies; although others (26) have suggested that this instrument should be used with caution and with considering its limitations especially in mild asthma.