European Journal of Health Economics最新文献

{"title":"Comparing the measurement properties of the EQ-5D-5 L, SF-6Dv2, QLU-C10D and FACT-8D among survivors of classical Hodgkin's lymphoma.","authors":"Richard Huan Xu, Zuyi Zhao, Tianxin Pan, Andrea Monteiro, Hongfei Gu, Dong Dong","doi":"10.1007/s10198-024-01730-x","DOIUrl":"10.1007/s10198-024-01730-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the measurement properties of EQ-5D-5 L, SF-6Dv2, QLU-C10D, and FACT-8D in survivors of Classical Hodgkin's Lymphoma (CHL).</p><p><strong>Methods: </strong>A cross-sectional, web-based survey was conducted from May to August 2022 to collect data. Chinese value sets were used to estimate the utility scores for EQ-5D-5 L, SF-6Dv2, and QLU-C10D, while the Australian value set was used for FACT-8D. The measurement properties assessed included ceiling and floor effects, convergent validity (assessing associations between similar dimensions/utility scores using Spearman's rank correlation and intraclass correlation coefficient), and known-group validity (measures could differentiate health-related quality of life (HRQoL) between risk groups).</p><p><strong>Results: </strong>A total of 534 CHL survivors participated in the survey and completed the questionnaire. All dimensions of EQ-5D-5 L, SF-6D (except for vitality), QLU-C10D, and FACT-8D showed ceiling effects, ranging from 18 to 91.6%. The EQ-5D-5 L demonstrated the higher ceiling effects compared to other measures, with 33% of patients reporting full health on this scale. All 30 pairs of associations between similar dimensions from the four measures were statistically significant, with correlation coefficients ranging from 0.29 to 0.77. Regarding utility scores, the EQ-5D-5 L utility score showed a stronger correlation with SF-6Dv2 than with the other two measures. Statistically significant correlations of utility scores between the four measures were observed. EQ-5D-5 L can significantly differentiate HRQoL among all known-groups, while SF-6Dv2, QLU-C10D, and FACT-8D showed a less strong discriminant ability.</p><p><strong>Conclusions: </strong>EQ-5D-5 L outperformed SF-6Dv2 in terms of agreement with cancer-specific PRMs and discriminant ability. However, SF-6Dv2 showed stronger associations with similar dimensions of QLU-C10D and FACT-8D, indicating high convergent validity. The generic PBMs are sensitive enough to measure HRQoL in survivors of CHL.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"671-682"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing EQ-5D-5L, PROPr, SF-6D and TTO utilities in patients with chronic skin diseases.","authors":"Ákos Szabó, Valentin Brodszky, Fanni Rencz","doi":"10.1007/s10198-024-01728-5","DOIUrl":"10.1007/s10198-024-01728-5","url":null,"abstract":"<p><strong>Objectives: </strong>We aim to compare the measurement properties of three indirect (EQ-5D-5L, PROPr, SF-6D) and one direct (time trade-off, TTO) utility assessment methods in patients with chronic skin diseases.</p><p><strong>Methods: </strong>120 patients with physician-diagnosed chronic skin diseases (psoriasis 39%, atopic dermatitis 27%, acne 19%) completed a cross-sectional survey. Respondents completed the EQ-5D-5L, PROMIS-29+2 and SF-36v1 questionnaires and a 10-year TTO task for own current health. Utilities were computed using the US value sets. Ceiling, convergent and known-group validity were compared across the utilities derived with these four methods. Known-groups were defined based on general, physical and mental health. The agreement between utilities was assessed using intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>Mean utilities for the EQ-5D-5L, PROPr, SF-6D and TTO were 0.79, 0.47, 0.76 and 0.89. In corresponding order, the ceiling was 28%, 0%, 2% and 65%. The SF-6D showed excellent agreement with the EQ-5D-5L (ICC = 0.770). PROPr demonstrated poor agreement with the EQ-5D-5L (ICC = 0.381) and fair with SF-6D utilities (ICC = 0.445). TTO utilities showed poor agreement with indirectly assessed utilities (ICC = 0.058-0.242). The EQ-5D-5L better discriminated between known groups of general and physical health, while the SF-6D and PROPr outperformed the EQ-5D-5L for mental health problems.</p><p><strong>Conclusion: </strong>There is a great variability in utilities across the four methods in patients with chronic skin conditions. The EQ-5D-5L, despite its higher ceiling, appears to be the most efficient in discriminating between patient groups for physical health aspects. Our findings inform the choice of instrument for quality-adjusted life year calculations in cost-utility analyses.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"627-639"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse selection and consumer inertia: empirical evidence from the Dutch health insurance market.","authors":"Ramsis R Croes, Frederik T Schut, Marco Varkevisser","doi":"10.1007/s10198-024-01725-8","DOIUrl":"10.1007/s10198-024-01725-8","url":null,"abstract":"<p><p>This paper examines to what extent consumer inertia can reduce adverse selection in health insurance markets. To this end, we investigate consumer choice of deductible in the Dutch health insurance market over the period 2013-2018, using panel data based on a large random sample (266 k) of all insured individuals in the Netherlands. The Dutch health insurance market offers a unique setting for studying adverse selection, because during annual open enrollment periods all adults are free to choose an extra deductible up to 500 euro per year. By focusing on deductible choices of those who do not switch health plans, we are able to examine the 'pure' adverse selection effect (i.e., not distorted by other health plan attributes). We estimate a dynamic logit model to examine individuals' deductible choice. We find evidence of adverse selection, as people with higher previous health care cost are substantially less likely to take up or keep a 500-euro deductible. We also find that adverse selection is counteracted by a high level of consumer inertia, as the average partial effect on deductible choice of the previous selected deductible level is much larger than the average partial effect of a change in health care costs.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"641-651"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug pricing models, no 'one-size-fits-all' approach: a systematic review and critical evaluation of pricing models in an evolving pharmaceutical landscape.","authors":"Evert A Manders, Sibren van den Berg, Saco J de Visser, Carla E M Hollak","doi":"10.1007/s10198-024-01731-w","DOIUrl":"10.1007/s10198-024-01731-w","url":null,"abstract":"<p><p>Access to new medicines is crucial for patients but increasingly sparks discussion due to high prices. Simultaneously, the growing emphasis on specialized products and uncertainty surrounding the long-term effectiveness of new drug classes brought to the market underscore the need for innovative pricing approaches. A systematic literature review of pharmaceutical pricing models, accompanied by a critical appraisal, was conducted to offer insights contributing to novel approaches balancing sustainable pharmaceutical innovation with affordability and accessibility for patients. Six different pricing models are identified: value based pricing, basic cost-based pricing, and four more comprehensive pricing models incorporating numerous elements: the cancer-drug-pricing model, AIM model, (Nuijtens) discounted cash flow, and the real-option rate of return method. Although there are many similarities among the models, each has unique assumptions for implementation. For instance, all models except for the standard incremental cost-effectiveness ratio and basic cost-based pricing consider the number of eligible patients and the remaining patent period. Only the AIM model and the Nuijtens discounted cash flow model use lump sums. Both the latter and the real-option rate of return method explicitly include the cost of capital as a major cost-based component. Recognizing the diverse applications of each model highlights the need for more differential and dynamic pricing tailored to the characteristics and therapeutic areas of each drug. Additionally, the study underscores the importance of cost transparency in achieving this goal. Consequently, these findings can help stakeholders develop sustainable and affordable drug pricing mechanisms that address the complexities of the ever-changing pharmaceutical landscape.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"683-696"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of four approaches in eliciting health state utilities with SF-6Dv2.","authors":"Hosein Ameri, Thomas G Poder","doi":"10.1007/s10198-024-01723-w","DOIUrl":"10.1007/s10198-024-01723-w","url":null,"abstract":"<p><strong>Objective: </strong>To empirically compare four preference elicitation approaches, the discrete choice experiment with time (DCE_TTO), the Best-Worst Scaling with time (BWS_TTO), DCE_TTO with BWS_TTO (DCE_BWS), and the Standard Gamble (SG) method, in valuing health states using the SF-6Dv2.</p><p><strong>Methods: </strong>A representative sample of the general population in Quebec, Canada, completed 6 SG tasks or 13 DCE_BWS (i.e., 10 DCE_TTO followed by 3 BWS_TTO). Choice tasks were designed with the SF-6Dv2. Several models were used to estimate SG data, and the conditional logit model was used for the DCE or BWS data. The performance of SG models was assessed using prediction accuracy (mean absolute error [MAE]), goodness of fit using Bayesian information criterion (BIC), t-test, Jarque-Bera (JB) test,  Ljung-Box (LB) test, the logical consistency of the parameters, and significance levels. Comparison between approaches was conducted using acceptability (self-reported difficulty and quality levels in answering, and completion time), consistency (monotonicity of model coefficients), accuracy (standard errors), dimensions coefficient magnitude, correlation between the value sets estimated, and the range of estimated values. The variance scale factor was computed to assess individuals' consistency in their choices for DCE and BWS approaches.</p><p><strong>Results: </strong>Out of 828 people who completed SG and 1208 for DCE_BWS tasks, a total of 724 participants for SG and 1153 for DCE tasks were included for analysis. Although no significant difference was observed in self-reported difficulties and qualities in answers among approaches, the SG had the longest completion time and excluded participants in SG were more prone to report difficulties in answering. The range of standard errors of the SG was the narrowest (0.012 to 0.015), followed by BWS_TTO (0.023 to 0.035), DCE_BWS (0.028 to 0.050), and DCE_TTO (0.028 to 0.052). The highest number of insignificant and illogical parameters was for BWS_TTO. Pain dimension was the most important across dimensions in all approaches. The correlation between SG and DCE_BWS utility values was the strongest (0.928), followed by the SG and BWS_TTO values (0.889), and the SG and DCE_TTO (0.849). The range of utility values generated by SG tended to be shorter (-0.143 to 1) than those generated by the other three methods, whereas BWS_TTO (-0.505 to 1) range values were shorter than DCE_TTO (-1.063 to 1) and DCE_BWS (-0.637 to 1). The variance scale factor suggests that respondents had almost similar level of certainty or confidence in both DCE and BWS responses.</p><p><strong>Conclusion: </strong>The SG had the narrowest value set, the lowest completion rates, the longest completion time, the best prediction accurac","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"589-604"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332147","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}

{"title":"Does implementing opt-out solve the organ shortage problem? Evidence from a synthetic control approach.","authors":"Selina Schulze Spuentrup","doi":"10.1007/s10198-024-01716-9","DOIUrl":"10.1007/s10198-024-01716-9","url":null,"abstract":"<p><p>In light of the persistent shortage of organ donations needed to save precious human lives, several countries have modified their organ donation laws by introducing an opt-out system, making every deceased a potential organ donor unless the person has objected. This study examines the impact of adopting opt-out on organ donation rates. Using a panel dataset covering a 21-year period, I apply a synthetic control approach to focus on countries that changed their prevailing organ donation legislation from opt-in to opt-out. I compare them to a synthetic counterfactual from countries that have kept their legislation the same since 1999. Synthetic control estimates show that Argentina and Wales achieved substantially higher organ donation rates with the shift from an opt-in to an opt-out system than without the reform taking place. My findings suggest that as one strategy among others, implementing opt-out cannot solve the organ shortage problem entirely but effectively contributes to reducing it considerably.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"541-560"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300496","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}

{"title":"Benefits beyond health in the willingness to pay for a quality-adjusted life-year.","authors":"Linda M de Vries, Werner B F Brouwer, Pieter H M van Baal","doi":"10.1007/s10198-024-01726-7","DOIUrl":"10.1007/s10198-024-01726-7","url":null,"abstract":"<p><p>Adopting a societal perspective in cost-effectiveness analysis (CEA) requires including all societal costs and benefits even if they fall outside of the realm of health and healthcare. While some benefits are not explicitly included, they might be implicitly included when people value quality-adjusted life-years (QALYs) in monetary terms. An example is utility of consumption (UoC) which has played a crucial role in discussions regarding the welfare economic underpinnings of CEA. This study investigates whether people consider elements beyond health when valuing QALYs monetarily and the influence of inclusion on this value. A Willingness to Pay (WTP) experiment was administered among the general public in which people were asked to assign monetary values to QALYs. Our results show that (stated) UoC increases with quality of life but that instructing people to consider UoC does not impact their monetary valuation of the QALY. Furthermore, many respondents consider elements beyond health when valuing QALYs but the impact on the monetary value of a QALY is limited. These findings suggest that these elements are currently not (adequately) captured in CEA. Findings also illustrate that it is difficult to isolate health from non-health benefits and to consistently capture these in CEA. With that, reconciling CEA with welfare economics remains challenging.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"653-670"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing a decade of leukaemia-related premature mortality costs: impact on productivity loss in Spain.","authors":"Josep Darbà, Meritxell Ascanio, Ainoa Agüera","doi":"10.1007/s10198-024-01727-6","DOIUrl":"10.1007/s10198-024-01727-6","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer mortality is one of the dominant causes of productivity loss; and within all cancer sites, blood cancer is the fourth most common cause of death in Spain. Thus, its impacts in work productivity are a major concern and represent a high social impact. The aim of this study was to evaluate the productivity losses resulting from of premature deaths due to leukaemia in Spain.</p><p><strong>Methods: </strong>The productivity costs stemming from premature mortality due to leukaemia were estimated using the human capital method. Information pertaining to mortality rates, typical incomes, and joblessness figures was gathered throughout a decade-long period spanning from 2012 to 2021.</p><p><strong>Results: </strong>Leukaemia caused 40% of haematological malignancies losses. It represented a 3.39% of all cancer-related deaths. In addition, it was responsible for 7,851 years of potential productive life lost (YPLPLL) in 2021, and productivity losses of €4,206.52 million over the 10-year period. All these numbers are relevant for Spain as will help on a more efficient distribution of resource.</p><p><strong>Conclusions: </strong>These productivity losses obtained, highlight the burden of leukaemia on the Spanish population, providing novel data on the number of deaths, trends and productivity losses for this type of cancer. This evaluation offers fresh insights that can aid policymakers in efficiently distributing resources, thereby lessening the economic burden it imposes on individuals of working age.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"619-625"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pricing combination products: not how but who?","authors":"Adrian Towse, Andrew Briggs, Lotte Steuten","doi":"10.1007/s10198-025-01773-8","DOIUrl":"10.1007/s10198-025-01773-8","url":null,"abstract":"<p><p>In the last decade progress has been made in identifying solutions to the \"technical problem\" of attributing the value of combinations between component parts, but not in adapting mechanisms to implement solutions. We propose a way forward to address the \"mechanism problem\", arguing that it is essential HTA bodies and/or pricing and reimbursement authorities get actively involved in setting out attribution rules or methods. HTA and pricing/reimbursement authorities have, in essence, adopted one of three strategies: (i) \"Do nothing\"; (ii) Take a simplistic and arbitrary approach, such as the German law imposing a \"haircut\" of 20% on the prices of products used in combination or (iii) \"Passing the parcel\" to the companies and to competition authorities, hoping they will solve the problem for them. Even if a competition law compatible solution is possible, three challenges remain. First, the cost and effort of using it may be too high in relation to any likely gains. Second, the bargaining power of the backbone owner under current HTA / pricing rules is so high that, likely, no solutions that incentivise add-on therapy development will emerge from a process from which HTA bodies absent themselves. Third, most solutions emerging from such a process which give any returns to the add-on likely need the backbone to have a different price (i.e. lower) in combination use as compared to monotherapy use, requiring payer approval for multi-indication pricing. Resolution of the combination challenge thus requires HTA and reimbursement bodies involvement in value attribution.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"537-540"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of dialectical behavioural therapy versus treatment as usual for autism with suicidal behaviours: single-blind randomised controlled trial.","authors":"Anne Huntjens, Filip Smit, L M C van den Bosch, Ad Kerkhof, Bram Sizoo, Mark van der Gaag","doi":"10.1007/s10198-025-01794-3","DOIUrl":"https://doi.org/10.1007/s10198-025-01794-3","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the cost-effectiveness of dialectical behaviour therapy (DBT) compared to treatment as usual (TAU) for autistic adults with suicidal behaviours.</p><p><strong>Method: </strong>In a randomised controlled trial, 123 autistic outpatients were assessed over 12 months. Healthcare costs and societal costs were calculated in accordance with the Dutch standard. Outcomes were quality-adjusted life years (QALYs) and treatment response, defined as a reduction of at least 50% in symptoms of suicidal ideation from t₀-t₁₂ as measured by the Suicidal Ideation Attributes Scale (SIDAS), plus achieving SIDAS < 20 at t₁₂ (i.e. below the clinical threshold).</p><p><strong>Results: </strong>From the healthcare perspective, DBT cost €371 less than TAU while gaining an additional 0.184 QALYs, with a 64% likelihood of being the dominant treatment option. From the societal perspective, DBT has higher costs than TAU by €232 per QALY gained, which can be considered cost-effective given a willingness-to-pay of €50,000 per QALY. DBT also showed better treatment response rates, with less suicidal ideation, at lower costs than TAU. Sensitivity analyses supported these findings.</p><p><strong>Conclusion: </strong>DBT is a novel treatment for autistic adults with suicidality. It fills a significant treatment gap in lieu of any evidence-based alternative for this population. DBT reduces suicidality, enhances quality of life and is cost-effective across healthcare and societal perspectives, encouraging broader adoption. Future research should assess DBT's long-term impacts and its transferability to other countries and map pathways towards upscaled implementation.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192521","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}