Value in Health最新文献_第2页

The cost-effectiveness of community health workers in primary health care: a systematic review. 初级卫生保健中社区卫生工作者的成本效益：一项系统审查。

IF 6 2区医学

Value in Health Pub Date : 2025-09-20 DOI: 10.1016/j.jval.2025.09.004

Tijs Van Iseghem, Laura Vroonen, Emilie Op de Beeck, Annick Meertens, Caroline Masquillier, Edwin Wouters, Nick Verhaeghe

{"title":"The cost-effectiveness of community health workers in primary health care: a systematic review.","authors":"Tijs Van Iseghem, Laura Vroonen, Emilie Op de Beeck, Annick Meertens, Caroline Masquillier, Edwin Wouters, Nick Verhaeghe","doi":"10.1016/j.jval.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.jval.2025.09.004","url":null,"abstract":"Background: Global interest in community health worker (CHW) programs in primary health care (PHC) is rising due to their potential to advance universal health coverage and other global health goals. This systematic review examines the evidence on the cost-effectiveness of CHW interventions worldwide, with a focus on vulnerable populations in PHC settings.Methods: A systematic review was conducted using the PubMed, Embase, Web of Science Core Collection, SCOPUS and EconLit databases. The search was last updated on May 13, 2025. Two reviewers independently selected articles, rated their quality and extracted relevant data. Included articles had to be full economic evaluations comparing CHW interventions to usual care without CHWs, focussing on vulnerable populations in PHC. A standardized data extraction template was used and the reporting quality was assessed using the CHEERS checklist.Results: Fifty articles were included, originating from 25 countries. All but one of the economic evaluations were disease-specific, focusing mainly on maternal, newborn and child health, type 2 diabetes mellitus, tuberculosis, cardiovascular disease, mental health, and HIV. Most articles (n = 35, 70%) indicated that CHW interventions were (potentially) cost-effective. Fourteen out of these 35 articles can substantiate their findings with a probabilistic sensitivity analysis (PSA).Conclusion: This review found that CHWs can be cost-effective across multiple health domains, both in LMICs and HICs. The lack of PSA, together with heterogeneity in contexts, interventions and methods used to assess the cost-effectiveness of the CHW interventions makes it difficult to draw general conclusions about the value-for-money of CHWs in PHC.","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-Term Outcomes and Cost-Effectiveness of Artificial Intelligence for Breast Cancer Screening: A Modeling Study. 人工智能用于乳腺癌筛查的长期结果和成本效益：一项建模研究。

IF 6 2区医学

Value in Health Pub Date : 2025-09-20 DOI: 10.1016/j.jval.2025.09.005

Matthew Andersen, Ilana B Richman, Natalia Kunst

{"title":"Long-Term Outcomes and Cost-Effectiveness of Artificial Intelligence for Breast Cancer Screening: A Modeling Study.","authors":"Matthew Andersen, Ilana B Richman, Natalia Kunst","doi":"10.1016/j.jval.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.jval.2025.09.005","url":null,"abstract":"Background: Artificial intelligence (AI)-assisted breast cancer screening may improve diagnostic accuracy, but the long-term health outcomes and cost-effectiveness of AI assisted screening is unknown. We estimated benefits, harms, and cost-effectiveness of incorporating an AI product, Saige-DX, into standard screening with digital breast tomosynthesis (DBT).Methods: We developed a microsimulation model using nationally representative data from SEER (Surveillance, Epidemiology, and End Results), the Breast Cancer Surveillance Consortium, and published data on AI performance. The model compared biennial screening for women ages 40-74 using DBT to DBT plus AI. We estimated false positive and false negative screens, breast cancer cases by stage, and breast cancer deaths per 1000 women screened over a lifetime. We also estimated quality-adjusted life years (QALYs), costs, and the incremental cost effectiveness ratio (ICER).Results: In a cohort of 1000 women screened from ages 40-74, AI-assisted screening reduced false negative screens by 2.1 and false positives by 50 resulting in 0.33 fewer advanced breast cancer cases (regional or metastatic cancer) at diagnosis and 0.13 fewer breast cancer deaths compared to DBT alone. Screening with AI resulted in 3.09 additional QALYs and an increase in lifetime costs of $936,430 per 1000 women, yielding an ICER of $303,279 per QALY. In 98% of simulations, AI was not cost-effective at a $100,000/QALY willingness-to-pay threshold. Findings were not sensitive to changes in test characteristics likely to be observed in routine practice.Conclusions: AI-assisted breast cancer screening yielded modest reductions in breast cancer mortality, but at current pricing, AI is not cost-effective.","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What costs and benefits should be counted in health technology assessments and guidelines? The NICE perspective. 在卫生技术评估和指导方针中应考虑哪些成本和收益？NICE的视角。

IF 6 2区医学

Value in Health Pub Date : 2025-09-19 DOI: 10.1016/j.jval.2025.09.003

James Koh, Koonal Shah

{"title":"What costs and benefits should be counted in health technology assessments and guidelines? The NICE perspective.","authors":"James Koh, Koonal Shah","doi":"10.1016/j.jval.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.jval.2025.09.003","url":null,"abstract":"The perspective of an economic evaluation defines what types of benefit and cost are counted when assessing the value for money of a health intervention. The health sector perspective counts health outcomes and health system costs, whereas a societal perspective includes effects relevant to other forms of public expenditure, such as benefits to educational attainment or economic productivity. This paper describes how the National Institute for Health and Care Excellence (NICE) evaluated the arguments for and against the adoption of a societal perspective and articulates the rationale for its decision to retain a health sector perspective in its value-for-money assessments, but with flexibility to consider wider societal effects when they are especially relevant to the value of a health intervention. The appropriate perspective to take is dependent upon the objective function of the payer. Under specific conditions, a publicly-funded payer could optimise decision-making across public sector budgets by adopting a full societal perspective. However, there are a range of ethical, practical and methodological problems that arise when trying to implement a societal perspective. These include a lack of evidence on the opportunity cost of non-health outcomes to calculate net effects, no robust methodology to inform trade-offs between health and non-health sector outcomes and the discriminatory consequences of counting productivity effects. We discuss how these considerations are balanced against the need to consider the value of non-health effects during the technology evaluation and guideline production processes.","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of a preference weighting system for the parent proxy child chronic cough quality-of-life (PC-QoL) instrument. 家长代理儿童慢性咳嗽生活质量（PC-QoL）量表偏好加权系统的开发。

IF 6 2区医学

Value in Health Pub Date : 2025-09-19 DOI: 10.1016/j.jval.2025.09.002

Jack M Roberts, Julie M Marchant, Anne B Chang, Vikas Goyal, Sameera Jayan Senanayake, Steven M McPhail, Sanjeewa Kularatna

{"title":"Development of a preference weighting system for the parent proxy child chronic cough quality-of-life (PC-QoL) instrument.","authors":"Jack M Roberts, Julie M Marchant, Anne B Chang, Vikas Goyal, Sameera Jayan Senanayake, Steven M McPhail, Sanjeewa Kularatna","doi":"10.1016/j.jval.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.jval.2025.09.002","url":null,"abstract":"Background: Cough in children is the most common reason for seeking healthcare in Australia. When chronic, it is associated with decreased quality-of-life in parents/ carers and significant societal costs. Despite this, the spillover effect of chronic cough on parents/carers is seldom accounted for in economic evaluations of interventions. We aimed to develop a new method of estimating spillover health utility in this population in Australia.Methods: We conducted a discrete choice experiment (DCE) on hypothetical health states based on the PC-QoL. These were analyzed using a garbage class multinomial logit model (GCL). We also obtained VAS scores for 6 health states and mapped them to the latent DCE utilities, rescaling them to the 0-1 health utility scale required to estimate QALYs.Results: Five hundred and fifty participants broadly representative of Australian parents completed our survey. Parental concerns about their child being able to lead a normal life had the largest coefficients in the GCL. The resulting scoring algorithm had a minimum score of .21, and a maximum of 1 (full health) CONCLUSIONS: We have developed a new method of estimating spillover health utility values in parents of children with chronic cough in Australia. This study is also a use-case for the application of GCL in extracting respondent non-trading behavior, that may cause inaccurate preference estimates, and a VAS based anchoring methodological approach that could be iterated in further research. We have developed an R package and shiny app to allow the easy estimation of spillover utility scores from PC-QoL responses.","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Research Method, Conduct, and Reporting Considerations for Improving the Quality of Non-Hypothesis-Evaluating Treatment Effectiveness Analyses Using Real-World Data: An ISPOR Special Interest Group Report. 使用真实世界数据提高非假设评估治疗效果分析质量的研究方法、行为和报告考虑：ISPOR特别兴趣小组报告。

IF 6 2区医学

Value in Health Pub Date : 2025-09-13 DOI: 10.1016/j.jval.2025.08.009

引用次数: 0

ASCOT and ICECAP in decision-making: A review of NICE social care and public health guidelines. ASCOT和ICECAP在决策中的作用：NICE社会关怀和公共卫生指南综述

IF 6 2区医学

Value in Health Pub Date : 2025-09-12 DOI: 10.1016/j.jval.2025.08.021

Zhixin Zhang, Tuba Saygın Avşar, Sophie Cooper, Jeremy Dietz

{"title":"ASCOT and ICECAP in decision-making: A review of NICE social care and public health guidelines.","authors":"Zhixin Zhang, Tuba Saygın Avşar, Sophie Cooper, Jeremy Dietz","doi":"10.1016/j.jval.2025.08.021","DOIUrl":"https://doi.org/10.1016/j.jval.2025.08.021","url":null,"abstract":"Background: When the National Institute for Health and Care Excellence (NICE) assesses whether interventions in health and social care offer value for money, where possible, it considers health effects expressed in quality-adjusted life years (QALYs). NICE's preferred measure of health-related quality of life is the EQ-5D. For non-health effects, NICE cites ASCOT and ICECAP as possible outcomes. To date, their use in NICE guidelines has not been reviewed.Objectives: The aims of this study were to 1) review how ASCOT and ICECAP have been used in NICE social care and public health guidelines and 2) contextualize the review via expert interviews.Methods: NICE social care and public health guidelines published before 26/08/2025 were reviewed, and information on the use of ASCOT and ICECAP was extracted. Five experts were interviewed to contextualize review findings.Results: Of the eligible guidelines, ASCOT appeared as an outcome in 4% and ICECAP in 1%. Neither measure significantly impacted committee's decision-making. Interview findings were grouped into two themes: (1) reasons behind the limited use of these measures (with 3 subthemes: conceptual, system-wide issues and implementation challenges); and (2) ongoing developments and future opportunities.Conclusions: ASCOT and ICECAP appeared infrequently in the NICE guidelines reviewed, and when used, their impact on committee decision-making was limited-either due to trial-specific limitations or reliance on other forms of evidence. Experts suggested several barriers to the use of these measures, and although these barriers are not insurmountable, it is unclear if such measures may appear more in future NICE social care and public health guidelines.","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

PROM-ising Progress? Trends in Patient- and Clinician-Reported Outcome Measures in FDA Orphan Drug Labels. PROM-ising进展吗?FDA孤儿药标签中患者和临床报告结果测量的趋势。

IF 6 2区医学

Value in Health Pub Date : 2025-09-11 DOI: 10.1016/j.jval.2025.08.020

Kristen A Cribbs, Lucas T A Blackmore, Michael R McGovern, Betsy J Lahue

{"title":"PROM-ising Progress? Trends in Patient- and Clinician-Reported Outcome Measures in FDA Orphan Drug Labels.","authors":"Kristen A Cribbs, Lucas T A Blackmore, Michael R McGovern, Betsy J Lahue","doi":"10.1016/j.jval.2025.08.020","DOIUrl":"https://doi.org/10.1016/j.jval.2025.08.020","url":null,"abstract":"Objectives: This study examined trends in patient-reported outcome measure (PROM) and clinician-reported outcome measure (ClinROM) use in FDA orphan drug labels from 2018 to 2024, comparing PROM utilization with findings from 2002-2017.Methods: We reviewed FDA-approved orphan drug labels for new molecular entities (NMEs) and biologic license applications (BLAs) with orphan designation from January 1, 2018, to December 31, 2024. Eligible labels referenced a PROM and/or ClinROM. Data was abstracted on approval year, FDA expedited review pathway, study design, endpoint ranking, instrument category, outcomes measured, and published validation references. Descriptive and trend analyses (p<0.05) were conducted and PROM findings compared to 2002-2017 rates.Results: Among 207 eligible labels from 2018-2024, 13.5% included PROMs, 10.1% included ClinROMs, and 5.3% referenced both. PROM use increased 5.2% (13.5% vs. 8.3%) from 2002-2017. PROMs were primary endpoints in >60% of 2018-2024 labels-a modest increase since 2002-2017-and ClinROMs were primary in more than three-fourths. 'Rare Disease Specific' instruments were included in <50% of PROM- and ClinROM-based labels during both review periods, one-third or fewer of which were ranked as a primary endpoint. The majority of PROM and ClinROM instruments across review periods captured symptoms and had published validation references. Significant associations (p<0.05) were observed between endpoint ranking and instrument type for labels including PROMs as well as both PROMs and ClinROMs across review periods.Conclusions: PROM and ClinROM inclusion in FDA orphan drug labels is uncommon. Greater integration could improve care and better convey clinically meaningful treatment value.","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost Effectiveness of the 15 Drugs Selected for IPAY 2027 CMS Drug Price Negotiation. IPAY 2027 CMS药品价格谈判选择的15种药品成本效果分析

IF 6 2区医学

Value in Health Pub Date : 2025-09-10 DOI: 10.1016/j.jval.2025.08.019

Feng Xie, Ting Zhou, Yue Ma, Joshua T Cohen, Peter J Neumann

{"title":"Cost Effectiveness of the 15 Drugs Selected for IPAY 2027 CMS Drug Price Negotiation.","authors":"Feng Xie, Ting Zhou, Yue Ma, Joshua T Cohen, Peter J Neumann","doi":"10.1016/j.jval.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.jval.2025.08.019","url":null,"abstract":"Objective: To analyze published cost-effectiveness analyses (CEAs) for the 15 drugs selected for the Initial Price Applicability Year 2027 by the Centers for Medicare and Medicaid Services (CMS).Methods: We identified CEAs for the 15 drugs from the Tufts Cost-Effectiveness Analysis Registry. For each drug, we included all base-case incremental cost effectiveness ratios (ICERs) and calculated median and interquartile ranges for positive ICERs for each drug-indication. We also performed the analyses on CEAs conducted in the US, which used a lifetime horizon, or were industry-sponsored. We present all costs in 2022 US dollars.Results: A total of 20 drug-indications were included in the analysis. Most studies employed a non-societal perspective and were industry-sponsored. Median positive ICERs ranged from $1,800 (linagliptin) to $640,000 (acalabrutinib) with six drug-indications having a median ICER below $50,000 and 10 above $100,000. Among the 13 drug-indications with US-based CEAs, 11 had a median ICER near or above $100,000. Among CEAs with a lifetime horizon, seven drug-indications had a median ICER below $50,000 and five above $100,000. CEAs sponsored by industry had median ICERs above $100,000 for five drug indications. The median ICERs differed considerably between the two covered indications for semaglutide, linaclotide, and rifaximin.Conclusion: As CMS continues to implement its drug price negotiation program, promoting greater transparency and consistency in how value is defined and applied to pricing decisions will be essential. CEA can serve as an important source of evidence, ensuring that negotiated prices more closely reflect the benefits drugs provide.","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mental Health, Quality of Life, and Work Functioning of Parents of Children Who Have Died from Spinal Muscular Atrophy. 脊髓性肌萎缩症死亡儿童父母的心理健康、生活质量和工作功能

IF 6 2区医学

Value in Health Pub Date : 2025-09-10 DOI: 10.1016/j.jval.2025.08.018

Tara A Lavelle, Abigail Riley, Stacey Kowal, Sheila Shapouri, David Fox, Hanwen Zhang, Tamara Vesel, Lisa Belter, Colleen McCarthy O'Toole, Christina M Mulé, Debra Lerner

{"title":"Mental Health, Quality of Life, and Work Functioning of Parents of Children Who Have Died from Spinal Muscular Atrophy.","authors":"Tara A Lavelle, Abigail Riley, Stacey Kowal, Sheila Shapouri, David Fox, Hanwen Zhang, Tamara Vesel, Lisa Belter, Colleen McCarthy O'Toole, Christina M Mulé, Debra Lerner","doi":"10.1016/j.jval.2025.08.018","DOIUrl":"https://doi.org/10.1016/j.jval.2025.08.018","url":null,"abstract":"Objectives: Cost-effectiveness analysis (CEA) guidelines emphasize including all relevant costs and effects, but few studies include bereavement effects. This study evaluated health-related quality of life (HRQOL), work productivity, and mental health among parents of children who had died from spinal muscular atrophy (SMA) type 1, and how outcomes changed over time.Methods: From April-June 2023, we partnered with a patient advocacy organization, Cure SMA, to recruit and survey U.S. parents of children who had died from SMA type 1. Survey development included a literature review and qualitative interviews with bereaved SMA type 1 parents. The survey measured HRQOL (with the Short-Form 12-Item Survey-version 2), work productivity (Work Limitations Questionnaire), anxiety (General Anxiety Disorder-7), and depression (Patient Health Questionarie-9). We derived health utility values using the Short-Form Six-Dimension.Results: Of 72 responses, 70 completed over half the survey and were included in the analysis. Respondents were primarily mothers (79%); 89% were over age 34, and 84% identified as White. Health utility values were significantly (p<0.05) lower, and mild to moderate anxiety rates were significantly higher, than age- and gender-matched U.S. population norms for all parents. Parents bereaved within the last 10 years reported significantly higher productivity loss due to presenteeism, compared to matched norms. Absenteeism and rates of major depression were similar to or lower than matched norms for all parents.Conclusions: Bereaved parents face significant health and productivity limitations, particularly in the first 10 years following their child's death. CEAs of life-extending therapies should explore the inclusion of bereavement effects.","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health Inequality Aversion in the United States. 美国对健康不平等的厌恶。

IF 6 2区医学

Value in Health Pub Date : 2025-09-10 DOI: 10.1016/j.jval.2025.08.015

Julia F Slejko, Salomé Ricci, Susan dosReis, Richard Cookson, Stacey Kowal

{"title":"Health Inequality Aversion in the United States.","authors":"Julia F Slejko, Salomé Ricci, Susan dosReis, Richard Cookson, Stacey Kowal","doi":"10.1016/j.jval.2025.08.015","DOIUrl":"https://doi.org/10.1016/j.jval.2025.08.015","url":null,"abstract":"Objectives: Health inequality aversion parameters are used in distributional cost-effectiveness analysis (DCEA) and for direct equity-based weighting to reflect societal preferences for improving total health (\"efficiency\") and versus reducing health inequality between more and less socially advantaged groups (\"equity\"). We elicited a health inequality aversion parameter (IAP) for the US.Methods: We adapted a benefit trade-off (BTO) instrument used in a United Kingdom study. Participants comprised the adult general public from June - December 2023. The online survey comprised 1) demographics and health views questions, 2) instructional videos, 3) BTO exercise. The BTO asked participants to trade off quality-adjusted life expectancy from the better off to worse off quintiles of the US population, described by indicators of social vulnerability. Response patterns were classified into 15 ranks with corresponding IAPs and implied equity weights.Results: Among 1,864 complete responses, inequality aversion was assessed for 1,290 participants. The sample approximated US census data for gender, race/ethnicity and income. The median Atkinson parameter was 12.12; the corresponding equity weight was 6.7; and 88% were willing to trade off total health to reduce health inequality. Multivariable regression indicated no significant sub-group variation in trade-off responses by age or region, but lower income groups and ethnic minority groups were slightly more averse to health inequality.Conclusions: The inequality aversion statistics derived from this sample illustrate support for more robust and routine integration of equity concerns into health care decisions in the policy and health technology assessment arenas to advance DCEA in the US.","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0