Applied Health Economics and Health Policy最新文献

{"title":"The Challenge of Unit Cost Harmonisation: A French National Reference Unit Cost for Healthcare Services (the MOVIE Project).","authors":"Christel Castelli, Coralie Delettrez, Amandine Coffy, Svletana Artemova, Julie Bulsei, Katia Charriere, Sandra David-Tchouda, Benoît Dervaux, Vera Georgescu, Alicia Le Bras, Aubane L'hospital, Sandrine Loubière, Jennifer Margier, Arnaud Pagès, Hassan Serrier, Anne-Laure Soilly, Marie Viprey, Michaël Mounié, Nadège Costa","doi":"10.1007/s40258-026-01079-7","DOIUrl":"https://doi.org/10.1007/s40258-026-01079-7","url":null,"abstract":"<p><strong>Objective: </strong>The lack of standardised unit cost data is a major barrier to the quality and comparability of health economic evaluations in France. Although such evaluations are often required for reimbursement decisions, no national reference cost framework existed outside the hospital sector. The MOVIE project fills this gap by developing the first French reference unit cost framework for 22 healthcare services, using 2021 data from a representative sample of the National Health Data System.</p><p><strong>Methods: </strong>Total billed amounts, social health insurance reimbursements, and patient out-of-pocket payments were estimated, in line with the collective perspective recommended by French authorities. The methodology was structured into three steps and was repeated for each of the 22 healthcare services. Step 1 consisted of a comprehensive literature review. Step 2 consisted of developing and executing the data query plan using the 2021 ESND database and then defining the statistical unit. Step 3 aimed to verify the consistency of the database with official statistics, estimates derived from the 2% sample that were extrapolated to the national level and compared with annually published macro-level data from official institutions collected in Step 1.</p><p><strong>Results: </strong>In 2021, the mean consultation cost was estimated at €39.8 (SD €12.6) for General Practitioners (GPs) and €66.1 (SD €37.1) for specialist physicians. Results show wide variation in unit costs across services, with low variability for allied health care and GP visits, and high variability and strong right-skewness for services such as inpatient care, chemotherapy, and dental care. Mean consultation costs were higher than commonly used tariffs, reflecting additional fees and incentives.</p><p><strong>Conclusion: </strong>Overall, this framework improves quality and comparability of economic evaluations and supports better-informed healthcare decision-making in France.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Effectiveness of Sertraline for Preventing Domestic Violence Reoffending Among Highly Impulsive Violent Offenders in Australia: A Trial-Based Economic Evaluation.","authors":"Emaediong I Akpanekpo, Georgina M Chambers, Lee Knight, Peter W Schofield, Tony Butler","doi":"10.1007/s40258-026-01080-0","DOIUrl":"https://doi.org/10.1007/s40258-026-01080-0","url":null,"abstract":"<p><strong>Background: </strong>Domestic violence generates significant health and justice costs, yet there is little trial-based clinical or economic evidence on pharmacological interventions for high-risk offenders. We evaluated the cost effectiveness of sertraline for reducing domestic violence reoffending among men with serious violent offending histories and high impulsivity.</p><p><strong>Objective: </strong>The primary objective was to estimate the incremental cost per domestic violence reoffence prevented for sertraline compared with placebo from a government payer perspective over 24 months.</p><p><strong>Methods: </strong>We conducted a cost-effectiveness analysis alongside a 24-month, double-blind, randomised controlled trial in New South Wales, Australia, comparing sertraline (n = 319) with placebo (n = 311). Both randomised groups received identical clinical support. A prespecified non-randomised group (N-Rand; n = 166) included eligible men who did not proceed to randomisation. The primary economic outcome was incremental cost per domestic violence reoffence prevented from a government perspective. Uncertainty was characterised using a probabilistic sensitivity analysis.</p><p><strong>Results: </strong>Domestic violence reoffending was lower with sertraline than placebo (28.2% vs 35.9%; risk ratio 0.79, p = 0.039) and N-Rand (42.2%; risk ratio 0.67, p = 0.002). Relative to placebo, sertraline generated net savings of Australian dollars (A$) 4443 per participant (A$57,636 per domestic violence reoffence prevented), with criminal justice savings (A$4839) exceeding medication costs (A$396). Relative to N-Rand, net savings were A$3327 per participant (A$23,841 per domestic violence reoffence prevented). In priobabilistic sensitivity analysis, sertraline (compared to placebo) had a mean incremental cost of -A$4507 (95% uncertainty interval -A$9,433, A$249) and 0.077 domestic violence reoffences prevented (95% confidence interval 0.004, 0.149). Sertraline was dominant in 95.1% of simulations, and in 84.9% versus N-Rand.</p><p><strong>Conclusions: </strong>Allocation to sertraline was associated with lower government costs and fewer domestic violence reoffences than placebo among men with serious violent offending histories and high impulsivity. Each reoffence prevented represents a reduction in violence experienced by victims, partners and children. These findings support consideration of sertraline as an adjunct within intervention and diversion programmes for high-risk offenders, where clinically indicated.</p><p><strong>Clinical trial registration: </strong>Australian New Zealand Clinical Trials Registry Identifier: ACTRN12613000442707.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Community Health Worker Interventions for Type 2 Diabetes Mellitus: A Systematic Review.","authors":"Laura R Porterfield, H Shelton Brown, Dallin Swanson, Revathi Gnanasekaran, Patricia Rodriguez Espinosa, Xiaoying Yu, Elizabeth M Vaughan","doi":"10.1007/s40258-026-01081-z","DOIUrl":"10.1007/s40258-026-01081-z","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes contributes substantially to healthcare costs, disability, and premature mortality worldwide. Although community health worker (CHW) interventions improve glycemic outcomes and address social determinants of health, current cost-effectiveness evidence has not been systematically synthesized. We reviewed the economic evidence for CHW interventions in type 2 diabetes management.</p><p><strong>Methods: </strong>We searched Ovid MEDLINE, Scopus, CINAHL, and ProQuest from inception through August 2025 for peer-reviewed primary studies evaluating economic outcomes of CHW interventions for adults with type 2 diabetes. We extracted data and assessed study quality. Owing to heterogeneity in design, cost reporting, and limited variance estimates, we conducted a narrative synthesis.</p><p><strong>Results: </strong>Of 753 records, 11 met inclusion criteria. All studies focused on low-income and/or ethnic minority populations. Ten reported program costs ($29-6235 per patient/year; 2025 USD). Nine reported incremental cost-effectiveness ratios. Two of three short-term studies (< 5 years) found interventions cost-effective; all six long-term studies (≥ 20 years) found the same.</p><p><strong>Conclusions: </strong>Available evidence suggests that CHW interventions are likely cost-effective for adults with T2D, particularly when evaluated over longer time horizons.</p><p><strong>Prospero registration: </strong>CRD420251101900. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251101900 .</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Annual Atrial Fibrillation Screening Compared with Current Opportunistic Screening in Australian Primary Care: A Model-Based Economic Evaluation.","authors":"Ureni Halahakone, Sameera Senanayake, Victoria McCreanor, William Parsonage, David Brain","doi":"10.1007/s40258-026-01073-z","DOIUrl":"https://doi.org/10.1007/s40258-026-01073-z","url":null,"abstract":"<p><strong>Background: </strong>Although the guidelines recommend opportunistic screening for adults ≥ 65 years, screening for atrial fibrillation (AF) remains underutilised in Australia. The absence of guidance on how often to screen has resulted in variable practice and missed opportunities for AF detection. Previous studies have focused on handheld devices rather than 12-lead electrocardiogram (ECG) devices that are readily available in primary-care settings, and the evidence supporting an annual AF screening programme in Australia is limited. Therefore, the aim of this study is to compare the cost-effectiveness of an annual, structured, higher‑coverage opportunistic ECG screening approach (annual screening) with current unstructured opportunistic screening (current screening) in older adults in Australia.</p><p><strong>Methods: </strong>A Markov model was developed to evaluate two strategies for adults ≥ 65 years: (1) annual screening using 12-lead ECG and (2) current opportunistic screening. The model included 11 health states capturing AF treatment and outcomes, and simulations were run using monthly cycles. A health system perspective and 10-year time horizon were applied. To account for uncertainty, a probabilistic sensitivity analysis with 1000 iterations was undertaken and the results were assessed against a cost-effectiveness threshold of 28,000 Australian dollars (AU$) per quality-adjusted life year (QALY). Uncertainty was further examined through cost-effectiveness acceptability curves and scenario analyses to test the stability of findings under alternative assumptions.</p><p><strong>Results: </strong>Annual screening increased costs by AU$4213 and gained 0.43 QALYs, yielding an incremental cost-effectiveness ratio of AU$9797 per QALY gained. Probabilistic sensitivity analysis demonstrated that 100% of simulations yielded a positive incremental net monetary benefit. Scenario analyses demonstrated that both higher screening costs and less frequent 3-yearly screening were cost-effective in comparison to the current opportunistic screening, with incremental cost-effectiveness ratios below the cost-effectiveness threshold and positive incremental net monetary benefits in all scenarios.</p><p><strong>Conclusion: </strong>A structured annual screening approach for AF is likely to be a cost-effective strategy within the Australian primary-care setting. These findings highlight the benefits of more consistent screening practices for early AF detection and stroke prevention.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speed over Value: Korea's Recent Overhaul in Pharmaceutical Pricing and Reimbursement.","authors":"Hye-Young Kwon","doi":"10.1007/s40258-026-01078-8","DOIUrl":"https://doi.org/10.1007/s40258-026-01078-8","url":null,"abstract":"<p><p>Since 2007, South Korea has been a leading country in Asia in health technology assessment (HTA). In March 2026, a 100-day listing pathway using international reference pricing (IRP) without pre-reimbursement HTA was introduced for rare disease drugs, with plans to expand to all new drugs. This policy represents a fundamental shift from ex-ante to ex-post value assessment, de-prioritizing the cost-effectiveness analysis framework established in 2007. Given the lessons from IRP, the global movement toward value-based pricing, and Korea's current financial challenges, it is essential to develop a system that leverages the accumulated knowledge on HTA over the past two decades to balance expedited access with rigorous value assessment. Therefore, further specified post-evaluation mechanisms incorporating value for money principles are needed to avoid undermining value assessment and diverging from the global trend toward strengthening value-based healthcare.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Early Value Assessment of Biomarker-Guided Precision Medicine for Treatment-Resistant Hypertension: A Headroom and Threshold Analysis.","authors":"Teebah Abu-Zahra, Sabine Grimm, Mirre Scholte, Ana I Casas, Peter Saliba-Gustafsson, Paolo Parini, Manuela Joore","doi":"10.1007/s40258-026-01075-x","DOIUrl":"https://doi.org/10.1007/s40258-026-01075-x","url":null,"abstract":"<p><strong>Background: </strong>Treatment-resistant hypertension (TRH), defined as uncontrolled blood pressure despite the use of three or more antihypertensive drugs or requiring four or more drugs for control, affects 10.3% of patients with hypertension and increases cardiovascular risk. Biomarker-guided precision treatments have the potential to address unmet needs in TRH. This health economic modelling study assessed the headroom (that is the maximum potential value of a hypothetical biomarker-guided treatment strategy with zero treatment costs and 100% effectiveness) in the TRH population in general, then in a specific subgroup with elevated levels of NADPH oxidase 5 (NOX5-positive).</p><p><strong>Methods: </strong>A decision tree and a state transition model were developed to estimate headroom in patients with TRH and in the NOX5-positive subgroup (assumed to comprise 25% of the population). The model adopted a Dutch healthcare perspective over a lifetime horizon, estimating costs and quality-adjusted life years (QALYs), with a net monetary benefit threshold of €20,000 per QALY. Uncertainty was explored through sensitivity, scenario and threshold analyses.</p><p><strong>Results: </strong>The room for improvement in TRH patients includes 2.94 additional life years, 3.45 QALYs, and €23,292 cost savings per patient. Successfully diagnosing and treating NOX5-positive patients could yield a gain of 0.53 life years and 0.63 QALYs, with cost savings of €4835 per patient. The biomarker-guided treatment remained cost effective even at annual costs of €5045 per patient or if only two of 1000 patients were NOX5-positive and successfully treated.</p><p><strong>Conclusion: </strong>Patients with TRH have room for improvement in life expectancy, quality of life, and cardiovascular outcomes with a biomarker-guided treatment strategy. These findings support further research and development of targeted treatments to address this unmet medical need.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Practical Framework for Understanding Cost-Effectiveness and Decision Risk in Health Benefits Package Design.","authors":"Cassandra Nemzoff, Sabine Grimm, Manuela Joore, Andres Madriz-Montero, Stella Matutina Umuhoza, James Humuza, Sedona Sweeney, Rob Baltussen, Anna Vassall","doi":"10.1007/s40258-026-01072-0","DOIUrl":"https://doi.org/10.1007/s40258-026-01072-0","url":null,"abstract":"<p><strong>Background: </strong>Global cost-effectiveness evidence is often used in health benefits package (HBP) assessments but is uncertain and subject to the risk of making the wrong decision. HBP assessments use 'adaptive' health technology assessment (aHTA) methods, including reviews of existing cost effectiveness studies and eliciting expert opinion to expedite cost-effectiveness evaluations due to substantial time and data constraints. Using aHTA methods poses a risk of making the wrong decision. However, existing methods for assessing risk, such as value of information analysis (VOI), are time- and data-intensive.</p><p><strong>Objectives: </strong>Our objectives were to develop a practical method to evaluate the risk of making the wrong decision in HBP design and to test this approach in Rwanda.</p><p><strong>Methods: </strong>We developed a heuristic framework to help decision makers determine whether aHTA methods are sufficient for decision making or de novo cost-effectiveness modelling might be needed. The framework was created by adapting the 'Appraisal of Risk Chart' (ARCH), which was originally designed to evaluate the risk of decision making from de novo cost-effectiveness analyses. We tested the adapted ARCH using an assessment of 136 cancer interventions in Rwanda, where each intervention was charted on the ARCH according to its risk profile.</p><p><strong>Results: </strong>In Rwanda, 41 cancer interventions were considered low risk on the ARCH and the remainder were uncertain.</p><p><strong>Conclusions: </strong>We demonstrate that it is feasible to use the ARCH to determine whether aHTA methods are sufficient or more research is needed in HBP assessments.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spillover Effects of Medical Innovations: A Universal and Scalable Approach to Measure the Societal Value of Avoided Informal Care Time.","authors":"Rebecca Grün, Diego Hernandez, Adnan Atitallah, Platon Peristeris, Lena Steinbeck, Eva Levi, Malina Müller","doi":"10.1007/s40258-026-01068-w","DOIUrl":"https://doi.org/10.1007/s40258-026-01068-w","url":null,"abstract":"<p><strong>Background and objective: </strong>Informal caregiving is essential to comprehensive patient care, yet sustained caregiving can lower caregivers' quality of life and productivity, with implications for labor supply and economic growth. Most studies quantify caregiver burden without linking it to patients' utility, obscuring how health gains translate into caregiving demand. We extend a published framework for valuing the social impact of medical interventions by incorporating informal caregiving as a scalable dimension of societal value, enabling estimation of caregiver productivity effects where direct caregiver data are unavailable.</p><p><strong>Methods: </strong>We established a generic relationship between patients' quality-adjusted life-years (QALYs) and caregiving time by leveraging published correlations between EQ-5D and daily care time. Incremental QALYs were converted into age- and ICD10 chapter-specific hourly reductions in caregiving time. To address the \"QALY-trap,\" we established a QALY-composition approximation. Using nationally representative time-use data, we estimated how freed time is reallocated to paid work, unpaid work, and leisure, and we quantified the socioeconomic value of avoided informal care time as opportunity costs, including direct effects on paid and unpaid work and broader impacts.</p><p><strong>Results: </strong>We demonstrated use in a case study of relapsing-remitting multiple sclerosis treated with ofatumumab across five countries. Ofatumumab reduced informal caregiving between 17.34 and 18.38 h per treated patient-year. In Germany, caregiver productivity gains were $468 per patient-year and represented about 7.2% of the patient productivity component of total social impact. Findings were directionally similar across settings.</p><p><strong>Conclusions: </strong>The method incorporates the caregiver perspective into economic evaluations by linking patient utility gains to changes in caregiving demand and their societal consequences. The framework provides a transparent and transferable approximation for estimating caregiver productivity spillovers when direct caregiver data are unavailable.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the Share of Social Surplus Generated by Pharmaceutical Innovation Accruing to Manufacturers: A Systematic Literature Review.","authors":"Robert J Nordyke, Tyler D Wagner, Janine Ross, Sreeranjani Menon, Jonathan D Campbell","doi":"10.1007/s40258-026-01064-0","DOIUrl":"https://doi.org/10.1007/s40258-026-01064-0","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmaceutical innovation operates within an implicit social contract that seeks to balance incentives for future drug development with equitable access to current therapies. A key metric for evaluating this balance is producer surplus (PS), which represents the share of total social surplus (the sum of consumer surplus [CS] and PS) captured by manufacturers. We explore the determinants and distribution of estimated supply-side surplus share across therapeutic areas, drug classes, and product life cycles.</p><p><strong>Methods: </strong>We conducted a systematic literature review of empirical studies on PS in pharmaceuticals. Embase and EconLit databases were searched from database inception to April 2025. Search practices followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidance.</p><p><strong>Results: </strong>A total of 24 studies were included, representing 68 unique PS estimates. Our analysis reveals wide variation in PS estimates, from 0.3% to 260%, with a median of approximately 15%. The range of estimates is driven primarily by disease-specific factors and methodological inconsistencies. Notably, most studies fail to account for the full spectrum of social benefits or to accurately identify manufacturer revenues, often conflating PS with broader supply chain gains. Only one study met rigorous criteria for both PS and CS definitions.</p><p><strong>Conclusion: </strong>The limitations of current studies on PS hinder the utility of PS in value assessment and policymaking. We argue for greater methodological rigor and consistency to improve PS estimation and inform sustainable public policy.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Mongolia's Sugar-Sweetened Beverage Tax: A Cost-Effectiveness Analysis.","authors":"Nyamdavaa Byambadorj, Rohan Best, Undram Mandakh, Kompal Sinha","doi":"10.1007/s40258-026-01070-2","DOIUrl":"https://doi.org/10.1007/s40258-026-01070-2","url":null,"abstract":"<p><strong>Background: </strong>Mongolia has approved a tax of 20% on sugar-sweetened beverages (SSBs) to take effect in 2027, yet while prior work has assessed potential health impacts, no peer-reviewed study has evaluated its cost-effectiveness.</p><p><strong>Objective: </strong>This study evaluates the cost-effectiveness of Mongolia's planned SSB tax by estimating its effect on health outcomes, healthcare costs, and changes in SSB consumption patterns.</p><p><strong>Methods: </strong>Using a Markov cohort model, we project outcomes over 10-year, 20-year and lifetime horizons. The model incorporates changes in the prevalence of overweight and obesity, noncommunicable disease (NCD) incidence, and associated costs, with primary outcomes measured in disability-adjusted life years (DALYs) averted, and quality-adjusted life years (QALYs) gained. To improve precision, disease risk estimates are informed by biomarker data, such as blood sugar and lipid levels, minimizing reliance on self-reported health indicators.</p><p><strong>Results: </strong>The ad valorem tax of 20% is projected to reduce consumption of SSBs by 31% through consumer price response alone. Accounting for additional calorie reductions from 20% industry reformulation, the combined effective reduction in SSB-related energy intake reaches approximately 45%. Across the three time horizons, the tax could avert 13, 260 and 2255 premature deaths; yield 2899, 14,362 and 33,613 QALYs; and avert US$6.13 million, US$30.34 million and US$71.02 million, respectively, in healthcare costs. From the healthcare perspective, the tax is cost-effective over 10 years (net cost US$1.77 million; incremental cost-effectiveness ratio (ICER) US$611.99/QALY) and becomes cost-saving within 20 years and over the lifetime horizon.</p><p><strong>Conclusions: </strong>These findings support the implementation of the SSB tax as a strategy to reduce Mongolia's NCD burden and generate long-term fiscal and health benefits.</p>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}