Health Economics Policy and Law最新文献_第2页

Medical marijuana laws and mental health in the United States. 美国的医用大麻法律与精神健康。

IF 1.7 3区医学

Health Economics Policy and Law Pub Date : 2024-04-02 DOI: 10.1017/S1744133124000033

Jörg Kalbfuss, Reto Odermatt, Alois Stutzer

引用次数: 0

The roads to managed competition for mixed public-private health systems: a conceptual framework. 公私混合医疗系统的管理竞争之路：概念框架。

IF 1.7 3区医学

Health Economics Policy and Law Pub Date : 2024-04-02 DOI: 10.1017/S1744133123000373

Josefa Henriquez, Wynand van de Ven, Adrian Melia, Francesco Paolucci

引用次数: 0

A review of heath economic evaluation practice in the Netherlands: are we moving forward? 荷兰医疗经济评估实践回顾：我们是否在前进？

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-04-01 Epub Date: 2023-06-06 DOI: 10.1017/S1744133123000087

Andrea Gabrio

{"title":"A review of heath economic evaluation practice in the Netherlands: are we moving forward?","authors":"Andrea Gabrio","doi":"10.1017/S1744133123000087","DOIUrl":"10.1017/S1744133123000087","url":null,"abstract":"Economic evaluations have been increasingly conducted in different countries to aid national decision-making bodies in resource allocation problems based on current and prospective evidence on costs and effects data for a set of competing health care interventions. In 2016, the Dutch National Health Care Institute issued new guidelines that aggregated and updated previous recommendations on key elements for conducting economic evaluation. However, the impact on standard practice after the introduction of the guidelines in terms of design, methodology and reporting choices, is still uncertain. To assess this impact, we examine and compare key analysis components of economic evaluations conducted in the Netherlands before (2010-2015) and after (2016-2020) the introduction of the recent guidelines. We specifically focus on two aspects of the analysis that are crucial in determining the plausibility of the results: statistical methodology and missing data handling. Our review shows how, over the last period, many components of economic evaluations have changed in accordance with the new recommendations towards more transparent and advanced analytic approaches. However, potential limitations are identified in terms of the use of less advanced statistical software together with rarely satisfactory information to support the choice of missing data methods, especially in sensitivity analysis.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Understanding household healthcare expenditure can promote health policy reform. 了解家庭医疗支出可促进医疗政策改革。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-04-01 Epub Date: 2023-08-17 DOI: 10.1017/S1744133123000129

Rohan Best, Berna Tuncay

{"title":"Understanding household healthcare expenditure can promote health policy reform.","authors":"Rohan Best, Berna Tuncay","doi":"10.1017/S1744133123000129","DOIUrl":"10.1017/S1744133123000129","url":null,"abstract":"Studies of health care expenditure often exclude explanatory variables measuring wealth, despite the intuitive importance and policy relevance. We use the Household, Income and Labour Dynamics in Australia Survey to assess impacts of income and wealth on health expenditure. We investigate four different dependent variables related to health expenditure and use three main methodological approaches. These approaches include a first difference model and introduction of a lagged dependent variable into a cross-sectional context. The key findings include that wealth tends to be more important than income in identifying variation in health expenditure. This applies for health variables which are not directly linked to means testing, such as spending on health practitioners and for being unable to afford required medical treatment. In contrast, the paper includes no evidence of different impacts of income and wealth on spending on medicines, prescriptions or pharmaceuticals. The results motivate two novel policy innovations. One is the introduction of an asset test for determining rebate eligibility for private health insurance. The second is greater focus on asset testing, rather than income tests, for a wide range of general welfare payments that can be used for health expenditure. Australia's world-leading use of means testing can provide a test case for many countries.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10367861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment. 我们需要讨论价值观：一个在卫生技术评估中阐明规范推理的拟议框架。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-04-01 Epub Date: 2023-09-27 DOI: 10.1017/S1744133123000038

Victoria Charlton, Michael DiStefano, Polly Mitchell, Liz Morrell, Leah Rand, Gabriele Badano, Rachel Baker, Michael Calnan, Kalipso Chalkidou, Anthony Culyer, Daniel Howdon, Dyfrig Hughes, James Lomas, Catherine Max, Christopher McCabe, James F O'Mahony, Mike Paulden, Zack Pemberton-Whiteley, Annette Rid, Paul Scuffham, Mark Sculpher, Koonal Shah, Albert Weale, Gry Wester

{"title":"We need to talk about values: a proposed framework for the articulation of normative reasoning in health technology assessment.","authors":"Victoria Charlton, Michael DiStefano, Polly Mitchell, Liz Morrell, Leah Rand, Gabriele Badano, Rachel Baker, Michael Calnan, Kalipso Chalkidou, Anthony Culyer, Daniel Howdon, Dyfrig Hughes, James Lomas, Catherine Max, Christopher McCabe, James F O'Mahony, Mike Paulden, Zack Pemberton-Whiteley, Annette Rid, Paul Scuffham, Mark Sculpher, Koonal Shah, Albert Weale, Gry Wester","doi":"10.1017/S1744133123000038","DOIUrl":"10.1017/S1744133123000038","url":null,"abstract":"It is acknowledged that health technology assessment (HTA) is an inherently value-based activity that makes use of normative reasoning alongside empirical evidence. But the language used to conceptualise and articulate HTA's normative aspects is demonstrably unnuanced, imprecise, and inconsistently employed, undermining transparency and preventing proper scrutiny of the rationales on which decisions are based. This paper - developed through a cross-disciplinary collaboration of 24 researchers with expertise in healthcare priority-setting - seeks to address this problem by offering a clear definition of key terms and distinguishing between the types of normative commitment invoked during HTA, thus providing a novel conceptual framework for the articulation of reasoning. Through application to a hypothetical case, it is illustrated how this framework can operate as a practical tool through which HTA practitioners and policymakers can enhance the transparency and coherence of their decision-making, while enabling others to hold them more easily to account. The framework is offered as a starting point for further discussion amongst those with a desire to enhance the legitimacy and fairness of HTA by facilitating practical public reasoning, in which decisions are made on behalf of the public, in public view, through a chain of reasoning that withstands ethical scrutiny.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Ten years of German benefit assessment: price analysis for drugs with unproven additional benefit. 德国效益评估十年：未证实额外效益的药物价格分析。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-04-01 Epub Date: 2023-08-14 DOI: 10.1017/S1744133123000117

Katrin Kleining, Jan Laufenberg, Philip Thrun, Dorothee Ehlert, Jürgen Wasem, Arne Bartol

{"title":"Ten years of German benefit assessment: price analysis for drugs with unproven additional benefit.","authors":"Katrin Kleining, Jan Laufenberg, Philip Thrun, Dorothee Ehlert, Jürgen Wasem, Arne Bartol","doi":"10.1017/S1744133123000117","DOIUrl":"10.1017/S1744133123000117","url":null,"abstract":"Introduction: Since 2011, the prices for all new drugs in Germany are negotiated based on a benefit assessment. The purpose of this study was to analyze the price regulation of drugs with unproven additional benefit.Methods: Benefit assessment procedures from 2011 to 2020 were reviewed and selected through AMNOG Monitor and Lauer Taxe. Negotiated annual therapy costs, the annual costs of the most cost-efficient appropriate comparative therapy (ACT) and the potential budget impact for 33 included procedures were calculated.Results: 55% of the included drugs achieved a negotiated price higher than the most cost-efficient ACT, 3% were identified as equal and 42% showed lower negotiated prices. The potential savings exceeded expenditures by around EUR 523.5 m. After price flexibility was adopted by the legislator in 2017, the overall potential savings still outweighed the expenditures by around EUR 62 m.Conclusions: Our analysis shows that making price negotiations more flexible by law does not undermine the fundamental aim of the AMNOG, which is to avoid additional expenditure without increased patient benefit. The regulation can thus fulfill the objective provided by the legislature of keeping drugs without proven additional benefits in the German healthcare system.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

New governance of the digital health agency: a way out of the joint decision trap to implement electronic health records in Germany? 数字医疗机构的新管理：德国实施电子病历的联合决策陷阱的出路？

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-04-01 Epub Date: 2023-09-11 DOI: 10.1017/S1744133123000142

Tugce Schmitt

{"title":"New governance of the digital health agency: a way out of the joint decision trap to implement electronic health records in Germany?","authors":"Tugce Schmitt","doi":"10.1017/S1744133123000142","DOIUrl":"10.1017/S1744133123000142","url":null,"abstract":"Fragmentation in health systems leads to discontinuities in the provision of health services, reduces the effectiveness of interventions, and increases costs. In international comparisons, Germany is notably lagging in the context of healthcare (data) integration. Despite various political efforts spanning decades, intersectoral care and integrated health data remain controversial and are still in an embryonic phase in the country. Even more than 2 years after its launch, electronic health record (elektronische Patientenakte; ePA) users in Germany constitute only 1 per cent of the statutorily insured population, and ongoing political debates suggest that the path to broader coverage is fraught with complexities. By exploring the main stakeholders in the existing (fragmented) health system governance in Germany and their sectoral interests, this paper examines the implementation of ePA through the lens of corporatism, offering insights based on an institutional decision theory. The central point is that endeavours to better integrate health data for clinical care, scientific research and evidence-informed policymaking in Germany will need to address the roles of corporatism and self-governance.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

How reforms hamper priority-setting in health care: an interview study with local decision-makers in London. 改革如何阻碍医疗保健优先事项的确定：对伦敦地方决策者的访谈研究。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-04-01 Epub Date: 2023-09-14 DOI: 10.1017/S174413312300021X

Katharina Kieslich, Clare Coultas, Peter Littlejohns

{"title":"How reforms hamper priority-setting in health care: an interview study with local decision-makers in London.","authors":"Katharina Kieslich, Clare Coultas, Peter Littlejohns","doi":"10.1017/S174413312300021X","DOIUrl":"10.1017/S174413312300021X","url":null,"abstract":"The fair allocation of scarce resources for health remains a salient topic in health care systems. Approaches for setting priorities in an equitable manner include technical ones based on health economic analyses, and ethical ones based on procedural justice. Knowledge on real-world factors that influence prioritisation at a local level, however, remains sparse. This article contributes to the empirical literature on priority-setting at the meso level by exploring how health care planners make decisions on which services to fund and to prioritise, and to what extent they consider principles of fair priority-setting. It presents the findings of an interview study with commissioners and stakeholders in South London between 2017 and 2018. Interviewees considered principles of fair prioritisation such as transparency and accountability important for offering guidance. However, the data show that in practice the adherence to principles is hampered by the difficulty of conceptualising and operationalising principles on the one hand, and the political realities in relation to reform processes on the other. To address this challenge, we apply insights from the policy and political sciences and propose a set of considerations by which current frameworks of priority-setting might be adapted to better incorporate issues of context and politics.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10580355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Pricing of hospital services: evidence from a thematic review. 医院服务定价：专题审查的证据。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-04-01 Epub Date: 2024-02-05 DOI: 10.1017/S1744133123000397

Andria J N Sirur, Rajasekharan Pillai K

{"title":"Pricing of hospital services: evidence from a thematic review.","authors":"Andria J N Sirur, Rajasekharan Pillai K","doi":"10.1017/S1744133123000397","DOIUrl":"10.1017/S1744133123000397","url":null,"abstract":"The management implications of pricing healthcare services, especially hospitals, have received insufficient scholarly attention. Additionally, disciplinary overlaps have led to scattered academic efforts in this domain. This study performs a thematic synthesis of the literature and applies retrospective analysis to hospital service pricing articles to address these issues. The study's inputs were sourced from well-known online repositories, using a structured search string and PRISMA flow chart to select the pertinent documents. Our thematic analysis of pricing literature encompasses: (a) comprehension of hospital service pricing nature; (b) pricing objectives, strategies and practices differentiation; (c) presentation of factors impacting hospital service pricing. We observe that hospital pricing is an intricate and unclear matter. The terms 'pricing strategies' and 'pricing practices' are often used interchangeably in academic literature. Hospital service pricing is influenced by costs, demand and supply factors, market structure, pricing regulation and third-party reimbursements. The study's findings provide policy implications for service pricing in hospitals, in addition to suggesting avenues for future research on hospital pricing.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Value assessment and decision-making: how to move health systems forward? 价值评估和决策：如何推动卫生系统向前发展？

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-04-01 Epub Date: 2024-07-10 DOI: 10.1017/S1744133124000082

Iris Wallenburg, Rocco Friebel

引用次数: 0