Health Economics Review最新文献

{"title":"Heterogeneous effects of hospital competition on inpatient quality: an analysis of five common diseases in China","authors":"Yinghui Lu, Qingling Jiang, Xueli Zhang, Xiaojun Lin, Jay Pan","doi":"10.1186/s13561-024-00504-8","DOIUrl":"https://doi.org/10.1186/s13561-024-00504-8","url":null,"abstract":"","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140707695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining confidential wholesale margin estimates in European countries for the price negotiation of patented drugs in Germany: a statistical model","authors":"Iris an der Heiden, Guido Schiffhorst, Laura Müller, Martin Albrecht, Arne Bartol, Stefanie Wiberny","doi":"10.1186/s13561-024-00503-9","DOIUrl":"https://doi.org/10.1186/s13561-024-00503-9","url":null,"abstract":"Based on the legal framework laid down in section 130b (9) of Book V of the German Social Code, various criteria are relevant for the negotiated price for new patented drugs in Germany. European reference prices (ERPs) are one criterion. The ERP is based on the ex-factory prices (EFPs) of the countries included in the European country basket. However, in some of these countries, the EFP is not published due to confidential wholesale margins. Wholesale margins must therefore be estimated and deducted from purchase prices. In this context literature-based estimates to date do not assume regressive margins with higher pharmaceutical prices. This assumption is questionable and can lead to systematically underestimated country prices, especially for high-priced drugs. Percentage wholesale margins in the majority of European countries develop to a comparable extent regressively with increasing prices. It should therefore be examined (1) whether statistical models can predict the margins of individual countries, in principle and especially for countries where margins are unknown and regressive trends are likely, and (2) to what extent the estimation of margins improves when regressive statistical models are used to estimate margins instead of cross-price averages published in the literature. Qualitative preliminary research explores the basic wholesale pricing mechanisms in countries with confidential wholesale margins. Wholesale margins for reimbursable drugs were then modeled for regulated European countries. Estimation quality and impact of the model was compared to estimations based on average margins. In both regulated countries and in countries with confidential wholesale margins, percentage margins of wholesalers develop regressively as drug prices rise. Regressive courses of margins can be resiliently modeled for the regulated countries using a power distribution with significantly lower mean squared errors in a linear mixed model in comparison to literature-based estimations with country-specific cross-price averages. If there is reason to believe that margins are regressive, confidential wholesale margins are expected to be better estimated by the power function based on margins of regulated countries than by the published country-specific average margins, reducing significantly inaccurate effects on margin estimations of high-price drugs.","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140591739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The long-term cost-effectiveness of once-weekly semaglutide versus sitagliptin for the treatment of type 2 diabetes in China.","authors":"Shuyan Gu, Jinghong Gu, Xiaoyong Wang, Xiaoling Wang, Lu Li, Hai Gu, Biao Xu","doi":"10.1186/s13561-024-00499-2","DOIUrl":"10.1186/s13561-024-00499-2","url":null,"abstract":"<p><strong>Background: </strong>To estimate the long-term cost-effectiveness of once-weekly semaglutide versus sitagliptin as an add-on therapy for type 2 diabetes patients inadequately controlled on metformin in China, to better inform healthcare decision making.</p><p><strong>Methods: </strong>The Cardiff diabetes model which is a Monte Carlo micro-simulation model was used to project short-term effects of once-weekly semaglutide versus sitagliptin into long-term outcomes. Short-term data of patient profiles and treatment effects were derived from the 30-week SUSTAIN China trial, in which 868 type 2 diabetes patients with a mean age of 53.1 years inadequately controlled on metformin were randomized to receive once-weekly semaglutide 0.5 mg, once-weekly semaglutide 1 mg, or sitagliptin 100 mg. Costs and quality-adjusted life years (QALYs) were estimated from a healthcare system perspective at a discount rate of 5%. Univariate sensitivity analysis, scenario analysis, and probabilistic sensitivity analysis were conducted to test the uncertainty.</p><p><strong>Results: </strong>Over patients' lifetime projections, patients in both once-weekly semaglutide 0.5 mg and 1 mg arms predicted less incidences of most vascular complications, mortality, and hypoglycemia, and lower total costs compared with those in sitagliptin arm. For an individual patient, compared with sitagliptin, once-weekly semaglutide 0.5 mg conferred a small QALY improvement of 0.08 and a lower cost of $5173, while once-weekly semaglutide 1 mg generated an incremental QALY benefit of 0.12 and a lower cost of $7142, as an add-on to metformin. Therefore, both doses of once-weekly semaglutide were considered dominant versus sitagliptin with more QALY benefits at lower costs.</p><p><strong>Conclusion: </strong>Once-weekly semaglutide may represent a cost-effective add-on therapy alternative to sitagliptin for type 2 diabetes patients inadequately controlled on metformin in China.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UHC in Morocco: a bottom-up estimation of public hospitals' financing size based on a costing database.","authors":"El Houcine Akhnif, Abdelouahab Belmadani, Awad Mataria, Maryam Bigdeli","doi":"10.1186/s13561-024-00501-x","DOIUrl":"10.1186/s13561-024-00501-x","url":null,"abstract":"<p><strong>Background: </strong>Morocco is engaged in a health system reform aimed at generalizing health insurance across the whole population by 2025. This study aims to build a national database of costs at all levels of public hospitals in Morocco and craft this database as a resource for further use in a strategic purchasing system. It also aims at estimating the funding gap and the budget that should be secured for public hospitals in Morocco to fully play their roles in the current ambitious reform.</p><p><strong>Method: </strong>A costing study was implemented in 39 hospitals in 12 regions of Morocco (10 provincial hospitals, 11 regional hospitals, and 18 teaching hospitals). Using the hospital costing approach, we adapted and validated nationally our methodology to generate a database of unit costs based on data from 2019. All perspectives on cost were considered. Data collection was performed by cadres from MoH and facilitated by the WHO country office in Morocco. The production of the cost database allowed the development of a bottom-up estimation of the financing size for public health hospitals.</p><p><strong>Results: </strong>The study showed the feasibility of large-scale costing in the context of Morocco. The ownership of MoH and adherence to the process ensured the high quality of the collected data. There are many differences in unit costs for the same services moving from one hospital to another, which indicates existing inefficiencies. The database will contribute to shaping the strategic purchasing mechanism within the generalized health insurance schemes. The studied hospitals could be used as references to systematically update the billing system for health insurance.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10983621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences in adolescents and young people's sexual and reproductive health services in Nigeria: a discrete choice experiment.","authors":"Olujide Arije, Jason Madan, Tintswalo Hlungwani","doi":"10.1186/s13561-024-00497-4","DOIUrl":"10.1186/s13561-024-00497-4","url":null,"abstract":"<p><strong>Background: </strong>Barriers to utilization of sexual and reproductive health (SRH) services by adolescents and young people (AYP) have persisted despite evidence that youth-friendly services have a positive effect on contraceptive use, and patient knowledge and satisfaction.</p><p><strong>Objective: </strong>The objective of this study was to elicit, and derive relative valuations for, attributes of SRH services that adolescents and young people value, and their willingness to pay for these services, in public health facilities.</p><p><strong>Methods: </strong>A discrete-choice-experiment (DCE) that was developed using a mixed methods approach was administered to AYP from Ogun State, Southwest Nigeria. The DCE attributes were: the type of staff; physical environment; health worker attitude; cost; waiting time; contraceptive availability; and opening hours. The choice tasks had two unlabeled alternatives and an opt-out option. Panel mixed logit choice model was used to fit the choice data, along with estimation of willingness to pay (WTP). Also, a latent class logit model was used to detect underlying preference heterogeneity among the respondents. Finally, the uptake of the services in health facilities was investigated by estimating the probabilities for selecting hypothetical health facilities under different scenarios.</p><p><strong>Results: </strong>A total of 859 AYP participated resulting in 6872 choice observations. The physical environment attribute had the highest utility rating relative to the other attributes, followed by preference for a doctor and for a service provider who was open and friendly. The cost and time coefficients were negative, revealing preference for lower cost and shorter waiting time. The latent class model had three classes that varied by their background characteristics. Probability of choosing any of the facility alternatives increased with introduction of more favorable facility characteristics.</p><p><strong>Conclusion: </strong>The pattern of preferences identified are potential targets for service design and delivery optimization that may result in improvements in service acceptability and utilization. These results strengthen the call for involving AYP in decision-making in health interventions for them and developing context-specific SRH programs for AYP in public health facilities.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insurance barriers and inequalities in health care access: evidence from dual practice.","authors":"Eva Goetjes, Katharina E Blankart","doi":"10.1186/s13561-024-00500-y","DOIUrl":"10.1186/s13561-024-00500-y","url":null,"abstract":"<p><strong>Background: </strong>We investigate access disparities in pharmaceutical care among German patients with type 2 diabetes, focusing on differences between public and private health insurance schemes. The primary objectives include investigating whether patients with private health insurance experience enhanced access to antidiabetic care and analyzing whether the treatment received by public and private patients is influenced by the practice composition, particularly the proportion of private patients.</p><p><strong>Methods: </strong>We estimate fixed effect regression models, to isolate the effect of insurance schemes on treatment choices. We utilize data from a prescriber panel comprising 681 physicians collectively serving 68,362 patients undergoing antidiabetic treatments.</p><p><strong>Results: </strong>The analysis reveals a significant effect of the patient's insurance status on antidiabetic care access. Patients covered by private insurance show a 10-percentage-point higher likelihood of receiving less complex treatments compared to those with public insurance. Furthermore, the composition of physicians' practices plays a crucial role in determining the likelihood of patients receiving less complex treatments. Notably, the most pronounced disparities in access are observed in practices mirroring the regional average composition.</p><p><strong>Conclusions: </strong>Our findings underscore strategic physician navigation across diverse health insurance schemes in ambulatory care settings, impacting patient access to innovative treatments.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The economic effect of financial compensation in China's healthcare system: comprehensive insights regarding supply and demand factors.","authors":"Yi Guo, Xuezhi Hong, Dongmei Li, Qiannan An, Wenwen Fan, Minghe Yang, Luyang Xiao","doi":"10.1186/s13561-024-00496-5","DOIUrl":"10.1186/s13561-024-00496-5","url":null,"abstract":"<p><strong>Objectives: </strong>We aim to analyse the effects of government subsidies on residents' health and healthcare expenditure from the perspectives of supply and demand.</p><p><strong>Data and methods: </strong>According to the regional division adopted in the data query system of the National Bureau of Statistics, this study divides 31 provinces and cities into three regions: eastern, central, and western. The data used are from public databases, such as the \"China Statistical Yearbook,\" \"China Health Statistical Yearbook,\" and \"Government Final Account Report\". In this study, mathematical model derivation is used to construct a fixed effects model, and an empirical study based on cross-sectional data and general linear regression is conducted. To prevent endogeneity issues, this study introduces instrumental variables and uses 2SLS regression to further analyse the output results.</p><p><strong>Results: </strong>For every 1% increase in supplementary funding on the supply side, the perinatal mortality rate decreases by 1.765%, while for every 1% increase in financial compensation on the demand side, per capita outpatient expenses increase by 0.225% and per capita hospitalization expenses increase by 0.196%. Regarding medical resources, for every 1% increase in the number of beds per 1,000 people, per capita hospitalization expenses decrease by 0.099%. In the central and eastern regions, where economic levels are higher, supply-side government funding is more effective than demand-side funding. In contrast, demand-side funding is more effective in the western region.</p><p><strong>Conclusions: </strong>The roles of multiple influencing factors and significant regional heterogeneity are clarified. Increasing financial compensation to providers positively impacts perinatal mortality but leads to higher per capita outpatient and hospital expenditures. Finally, this study provides targeted policy recommendations and solid theoretical support for policymakers.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of reimbursement systems on patient care - a systematic review of systematic reviews.","authors":"Eva Wagenschieber, Dominik Blunck","doi":"10.1186/s13561-024-00487-6","DOIUrl":"10.1186/s13561-024-00487-6","url":null,"abstract":"<p><strong>Background: </strong>There is not yet sufficient scientific evidence to answer the question of the extent to which different reimbursement systems influence patient care and treatment quality. Due to the asymmetry of information between physicians, health insurers and patients, market-based mechanisms are necessary to ensure the best possible patient care. The aim of this study is to investigate how reimbursement systems influence multiple areas of patient care in form of structure, process and outcome indicators.</p><p><strong>Methods: </strong>For this purpose, a systematic literature review of systematic reviews is conducted in the databases PubMed, Web of Science and the Cochrane Library. The reimbursement systems of salary, bundled payment, fee-for-service and value-based reimbursement are examined. Patient care is divided according to the three dimensions of structure, process, and outcome and evaluated in eight subcategories.</p><p><strong>Results: </strong>A total of 34 reviews of 971 underlying primary studies are included in this article. International studies identified the greatest effects in categories resource utilization and quality/health outcomes. Pay-for-performance and bundled payments were the most commonly studied models. Among the systems examined, fee-for-service and value-based reimbursement systems have the most positive impact on patient care.</p><p><strong>Conclusion: </strong>Patient care can be influenced by the choice of reimbursement system. The factors for successful implementation need to be further explored in future research.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Universal health coverage in the context of population ageing: catastrophic health expenditure and unmet need for healthcare","authors":"Shohei Okamoto, Mizuki Sata, Megumi Rosenberg, Natsuko Nakagoshi, Kazuki Kamimura, Kohei Komamura, Erika Kobayashi, Junko Sano, Yuzuki Hirazawa, Tomonori Okamura, Hiroyasu Iso","doi":"10.1186/s13561-024-00495-6","DOIUrl":"https://doi.org/10.1186/s13561-024-00495-6","url":null,"abstract":"<p><b>Correction to</b>: <b><i>Health Econ Rev </i></b><b>14, 8 (2024)</b></p><p>https://doi.org/10.1186/s13561-023-00475-2</p><p>Following the publication of the original article [1], the license copyright has been corrected to CC BY 3.0 IGO instead of Creative Commons Attribution 4.0 International License. The full correct copyright line should read as below:</p><p>© World Health Organization 2024. <b>Open Access</b> This article is licensed under the terms of the Creative Commons Attribution 3.0 IGO License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the World Health Organization, provide a link to the Creative Commons licence and indicate if changes were made. The use of the World Health Organization’s name, and the use of the World Health Organization’s logo, shall be subject to a separate written licence agreement between the World Health Organization and the user and is not authorized as part of this CC-IGO licence. Note that the link provided below includes additional terms and conditions of the licence. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/3.0/igo/.</p><p><b>Old Copyright Line</b>:</p><p>© World Health Organization 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.</p><p>The original article [1] has been updated.</p><ol data-track-component=\"outbound reference\"><li data-counter=\"1.\"><p>Okamoto S, Sata M, Rosenberg M, et al. Universal health coverage in the context of population ageing: catastrophic health exp","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140097943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Inequalities in unmet health care needs under universal health insurance coverage in China.","authors":"Jingxian Wu, Yongmei Yang, Ting Sun, Sucen He","doi":"10.1186/s13561-024-00494-7","DOIUrl":"10.1186/s13561-024-00494-7","url":null,"abstract":"","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10924981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}