Selecting Cost-Effectiveness Methods for Health Benefits Package Design: A Systematic Approach.

IF 5.1 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Cassandra Nemzoff, Sedona Sweeney, Rob Baltussen, Anna Vassall
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引用次数: 0

Abstract

Background: Cost-effectiveness (CE) is a common prioritization criterion in health benefits package (HBP) design. However, to assess CE is a time- and data-demanding process, so most HBP exercises rely wholly or partially on global evidence. Extensive investment has been made in analyses, models, and tools to support cost-effectiveness analyses (CEAs) for HBPs. However, little attention has been paid to how national HBP assessors should both understand and select CE estimates. A structured, national process to select assessment methods is essential for ensuring the accuracy, ownership, and transparency of HBP design. This can be supported by "adaptive" health technology assessment (aHTA) principles, which focus on structured methodological choices based on the time, data, and capacity available. The objective of this paper was to apply aHTA framing to CEA methods selection for HBPs, and to make recommendations on how countries may consider systematically making these choices going forward.

Methods: We first reviewed the definitions and categorization of different aHTA methods. We then conducted a scoping review of previous HBP assessments to understand how CEA methods used in HBPs fit into the aHTA framework, and a follow-up survey of authors to fill gaps. Results of the literature review and survey were interpreted and narratively synthesized.

Results: We found that previous HBP assessments used four aHTA methods, sometimes simultaneously: expert opinion (n=3/20), review (n=12/20), model adaptation (n=6/20), and new model (n=2/20). The literature review and survey found that aHTA methods for HBPs take between 1-13 months; require different data sources depending on the method(s) used; and generally, require capacity in health economics, medicine, public health, and CE modelling. We supplement our report with a discussion of key considerations for methods selection.

Conclusion: Trading off time, data, and capacity needs for different CE assessment methods can help to support structured, local design of HBP assessments.

Abstract Image

Abstract Image

选择成本效益方法的健康福利包装设计:一个系统的方法。
背景:成本效益(CE)是健康福利包(HBP)设计中常见的优先标准。然而,评估CE是一个需要时间和数据的过程,因此大多数HBP练习全部或部分依赖于全球证据。在分析、模型和工具方面进行了大量投资,以支持hbp的成本效益分析(cea)。然而,很少有人关注国家HBP评估人员应该如何理解和选择CE估计。一个结构化的、全国性的评估方法选择过程对于确保HBP设计的准确性、所有权和透明度至关重要。这可以得到“适应性”卫生技术评估原则的支持,该原则侧重于基于可用时间、数据和能力的结构化方法选择。本文的目的是将aHTA框架应用于HBPs的CEA方法选择,并就各国如何考虑系统地做出这些选择提出建议。方法:我们首先回顾了不同aHTA方法的定义和分类。然后,我们对先前的HBP评估进行了范围审查,以了解在HBP中使用的CEA方法如何适合aHTA框架,并对作者进行了后续调查以填补空白。对文献综述和调查结果进行解释和叙述综合。结果:我们发现以往的HBP评估使用了四种aHTA方法,有时同时使用:专家意见(n=3/20)、综述(n=12/20)、模型自适应(n=6/20)和新模型(n=2/20)。文献综述和调查发现,aHTA方法治疗HBPs需要1-13个月;根据使用的方法要求不同的数据源;一般来说,需要具备卫生经济学、医学、公共卫生和CE建模方面的能力。我们对方法选择的关键考虑因素进行了讨论,以补充我们的报告。结论:权衡不同CE评估方法的时间、数据和能力需求,有助于支持结构化、本地化的HBP评估设计。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Health Policy and Management
International Journal of Health Policy and Management Health Professions-Health Information Management
CiteScore
5.40
自引率
14.30%
发文量
142
审稿时长
9 weeks
期刊介绍: International Journal of Health Policy and Management (IJHPM) is a monthly open access, peer-reviewed journal which serves as an international and interdisciplinary setting for the dissemination of health policy and management research. It brings together individual specialties from different fields, notably health management/policy/economics, epidemiology, social/public policy, and philosophy into a dynamic academic mix.
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