Applied Health Economics and Health Policy最新文献

{"title":"Health Economics in a World of Uneconomic Growth","authors":"Martin Hensher,&nbsp;Gerry McCartney,&nbsp;Eleanor Ochodo","doi":"10.1007/s40258-024-00883-3","DOIUrl":"10.1007/s40258-024-00883-3","url":null,"abstract":"<div><p>Multiple, accelerating and interacting ecological crises are increasingly understood as constituting a major threat to human health and well-being. Unconstrained economic growth is strongly implicated in these growing crises, and it has been argued that this growth has now become “uneconomic growth”, which is a situation where the size of the economy is still expanding, but this expansion is causing more harm than benefit. This article summarises the multiple pathways by which uneconomic growth can be expected to harm human health. It describes how health care systems—especially through overuse, low value and poor quality care—can themselves drive uneconomic growth. Health economists need to understand not only the consequences of environmental impacts on health care, but also the significance of uneconomic growth, and pay closer attention to the growing body of work by heterodox economists, especially in the fields of ecological and feminist economics. This will involve paying closer heed to the existence and consequences of diminishing marginal returns to health care consumption at high levels; the central importance of inequalities and injustice in health; and the need to remedy health economists’ currently limited ability to deal effectively with low value care, overdiagnosis and overtreatment.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 4","pages":"427 - 433"},"PeriodicalIF":3.1,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40258-024-00883-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140629531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Evaluation of COVID-19 Immunization Strategies: A Systematic Review and Narrative Synthesis","authors":"Enxue Chang,&nbsp;Haofei Li,&nbsp;Wanji Zheng,&nbsp;Lan Zhou,&nbsp;Yanni Jia,&nbsp;Wen Gu,&nbsp;Yiyin Cao,&nbsp;Xiaoying Zhu,&nbsp;Juan Xu,&nbsp;Bo Liu,&nbsp;Mao You,&nbsp;Kejun Liu,&nbsp;Mingsi Wang,&nbsp;Weidong Huang","doi":"10.1007/s40258-024-00880-6","DOIUrl":"10.1007/s40258-024-00880-6","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to systematically assess global economic evaluation studies on COVID-19 vaccination, offer valuable insights for future economic evaluations, and assist policymakers in making evidence-based decisions regarding the implementation of COVID-19 vaccination.</p><h3>Methods</h3><p>Searches were performed from January 2020 to September 2023 across seven English databases (PubMed, Web of Science, MEDLINE, EBSCO, KCL-Korean Journal Dataset, SciELO Citation Index, and Derwent Innovations Index) and three Chinese databases (Wanfang Data, China Science and Technology Journal, and CNKI). Rigorous inclusion and exclusion criteria were applied. Data were extracted from eligible studies using a standardized data collection form, with the reporting quality of these studies assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022).</p><h3>Results</h3><p>Of the 40 studies included in the final review, the overall reporting quality was good, evidenced by a mean score of 22.6 (ranging from 10.5 to 28). Given the significant heterogeneity in fundamental aspects among the studies reviewed, a narrative synthesis was conducted. Most of these studies adopted a health system or societal perspective. They predominantly utilized a composite model, merging dynamic and static methods, within short to medium-term time horizons to simulate various vaccination strategies. The research strategies varied among studies, investigating different doses, dosages, brands, mechanisms, efficacies, vaccination coverage rates, deployment speeds, and priority target groups. Three pivotal parameters notably influenced the evaluation results: the vaccine's effectiveness, its cost, and the basic reproductive number (<i>R</i>₀). Despite variations in model structures, baseline parameters, and assumptions utilized, all studies identified a general trend that COVID-19 vaccination is cost-effective compared to no vaccination or intervention.</p><h3>Conclusions</h3><p>The current review confirmed that COVID-19 vaccination is a cost-effective alternative in preventing and controlling COVID-19. In addition, it highlights the profound impact of variables such as dose size, target population, vaccine efficacy, speed of vaccination, and diversity of vaccine brands and mechanisms on cost effectiveness, and also proposes practical and effective strategies for improving COVID-19 vaccination campaigns from the perspective of economic evaluation.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 4","pages":"457 - 470"},"PeriodicalIF":3.1,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140719999","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":"Model-Based Economic Evaluations of Interventions for Dementia: An Updated Systematic Review and Quality Assessment","authors":"Mohsen Ghaffari Darab,&nbsp;Lidia Engel,&nbsp;Dennis Henzler,&nbsp;Michael Lauerer,&nbsp;Eckhard Nagel,&nbsp;Vicki Brown,&nbsp;Cathrine Mihalopoulos","doi":"10.1007/s40258-024-00878-0","DOIUrl":"10.1007/s40258-024-00878-0","url":null,"abstract":"<div><h3>Background</h3><p>There has been an increase in model-based economic evaluations of interventions for dementia. The most recent systematic review of economic evaluations for dementia highlighted weaknesses in studies, including lack of justification for model assumptions and data inputs.</p><h3>Objective</h3><p>This study aimed to update the last published systematic review of model-based economic evaluations of interventions for dementia, including Alzheimer’s disease, with a focus on any methodological improvements and quality assessment of the studies.</p><h3>Methods</h3><p>Systematic searches in eight databases, including PubMed, Cochrane, Embase, CINAHL, PsycINFO, EconLit, international HTA database, and the Tufts Cost-Effectiveness Analysis Registry were undertaken from February 2018 until August 2022. The quality of the included studies was assessed using the Philips checklist and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist. The findings were summarized through narrative analysis.</p><h3>Results</h3><p>This review included 23 studies, comprising cost-utility analyses (87%), cost-benefit analyses (9%) and cost-effectiveness analyses (4%). The studies covered various interventions, including pharmacological (<i>n</i> = 10, 43%), non-pharmacological (<i>n</i> = 4, 17%), prevention (<i>n</i> = 4, 17%), diagnostic (<i>n</i> = 4, 17%) and integrated (<i>n</i> = 1, 4%) [diagnostics-pharmacologic] strategies. Markov transition models were commonly employed (65%), followed by decision trees (13%) and discrete-event simulation (9%). Several interventions from all categories were reported as being cost effective. The quality of reporting was suboptimal for the Methods and Results sections in almost all studies, although the majority of studies adequately addressed the decision problem, scope, and model-type selection in their economic evaluations. Regarding the quality of methodology, only a minority of studies addressed competing theories or clearly explained the rationale for model structure. Furthermore, few studies systematically identified key parameters or assessed data quality, and uncertainty was mostly addressed partially.</p><h3>Conclusions</h3><p>This review informs future research and resource allocation by providing insights into model-based economic evaluations for dementia interventions and highlighting areas for improvement.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 4","pages":"503 - 525"},"PeriodicalIF":3.1,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140329611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Hidden Toll of Psychological Distress in Australian Adults and Its Impact on Health-Related Quality of Life Measured as Health State Utilities","authors":"Muhammad Iftikhar ul Husnain,&nbsp;Mohammad Hajizadeh,&nbsp;Hasnat Ahmad,&nbsp;Rasheda Khanam","doi":"10.1007/s40258-024-00879-z","DOIUrl":"10.1007/s40258-024-00879-z","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Psychological distress (PD) is a major health problem that affects all aspects of health-related quality of life including physical, mental and social health, leading to a substantial human and economic burden. Studies have revealed a concerning rise in the prevalence of PD and various mental health conditions among Australians, particularly in female individuals. There is a scarcity of studies that estimate health state utilities (HSUs), which reflect the overall health-related quality of life in individuals with PD. No such studies have been conducted in Australia thus far.&lt;/p&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;We aimed to evaluate the age-specific, sex-specific and PD category-specific HSUs (disutilities) in Australian adults with PD to inform healthcare decision making in the management of PD.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Data on age, sex, SF-36/SF6D responses, Kessler psychological distress (K10) scale scores and other characteristics of &lt;i&gt;N&lt;/i&gt; = 15,139 participants (&lt;i&gt;n&lt;/i&gt; = 8149 female individuals) aged &gt;15 years were derived from the latest wave (21) of the nationally representative Household, Income and Labor Dynamics in Australia survey. Participants were grouped into the severity categories of no (K10 score: 10–19), mild (K10: 20–24), moderate (K10: 25–29) and severe PD (K10: 30–50). Both crude and adjusted HSUs were calculated from participants’ SF-36 profiles, considering potential confounders such as smoking, marital status, remoteness, education and income levels. The calculations were based on the SF-6D algorithm and aligned with Australian population norms. Additionally, the HSUs were stratified by age, sex and PD categories. Disutilities of PD, representing the mean difference between HSUs of people with PD and those without, were also calculated for each group.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The average age of individuals was 46.130 years (46% male), and 31% experienced PD in the last 4 weeks. Overall, individuals with PD had significantly lower mean HSUs than those likely to be no PD, 0.637 (95% confidence interval [CI] 0.636, 0.640) vs 0.776 (95% CI 0.775, 0.777) i.e. disutility: −0.139 [95% CI −0.139, −0.138]). Mean disutilities of −0.108 (95% CI −0.110, −0.104), −0.140 (95% CI −0.142, −0.138), and −0.188 (95% CI −0.190, −0.187) were observed for mild PD, moderate PD and severe PD, respectively. Disutilities of PD also differed by age and sex groups. For instance, female individuals had up to 0.049 points lower mean HSUs than male individuals across the three classifications of PD. There was a clear decline in health-related quality of life with increasing age, demonstrated by lower mean HSUs in older population age groups, that ranged from 0.818 (95% CI 0.817, 0.818) for the 15–24 years age group with no PD to 0.496 (95% CI 0.491, 0.500) for the 65+ years age group with severe PD). Across all ages and genders, respondents were more likely to report issues in certain dimensions, notably vitality, and these responses did ","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 4","pages":"583 - 598"},"PeriodicalIF":3.1,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140292570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Economic Evaluation and Care Commissioning Focused on Achieving the Same Outcomes? Resource-Allocation Considerations and Challenges Using England as a Case Study","authors":"Matthew Franklin,&nbsp;Sebastian Hinde,&nbsp;Rachael Maree Hunter,&nbsp;Gerry Richardson,&nbsp;William Whittaker","doi":"10.1007/s40258-024-00875-3","DOIUrl":"10.1007/s40258-024-00875-3","url":null,"abstract":"<div><p>Commissioning describes the process of contracting appropriate care services to address pre-identified needs through pre-agreed payment structures. Outcomes-based commissioning (i.e., paying services for pre-agreed outcomes) shares a common goal with economic evaluation: achieving value for money for relevant outcomes (e.g., health) achieved from a finite budget. We describe considerations and challenges as to the practical role of relevant outcomes for evaluation and commissioning, seeking to bridge a gap between economic evaluation evidence and care commissioning. We describe conceptual (e.g., what are ‘relevant’ outcomes) alongside practical considerations (e.g., quantifying and using relevant endpoint or surrogate outcomes) and pertinent issues when linking outcomes to commissioning-based payment mechanisms, using England as a case study. Economic evaluation often focuses on a single endpoint health-focused maximand, e.g., quality-adjusted life-years (QALYs), whereas commissioning often focuses on activity-based surrogate outcomes (e.g., health monitoring), as easier-to-measure key performance indicators that are more acceptable (e.g., by clinicians) and amenable to being linked with payment structures. However, payments linked to endpoint and/or surrogate outcomes can lead to market inefficiencies; for example, when surrogates do not have the intended causal effect on endpoint outcomes or when service activity focuses on only people who can achieve prespecified payment-linked outcomes. Accounting for and explaining direct links from commissioners’ payment structures to surrogate and then endpoint economic outcomes is a vital step to bridging a gap between economic evaluation approaches and commissioning. Decision-analytic models could aid this but they must be designed to account for relevant surrogate and endpoint outcomes, the payments assigned to such outcomes, and their interaction with the system commissioners purport to influence.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 4","pages":"435 - 445"},"PeriodicalIF":3.1,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140100872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Novel Agent Regimens for Transplant-Eligible Newly Diagnosed Multiple Myeloma Patients in India","authors":"Jyoti Dixit,&nbsp;Pankaj Malhotra,&nbsp;Nikita Mehra,&nbsp;Anisha Mathew,&nbsp;Lalit Kumar,&nbsp;Ashish Singh,&nbsp;Nidhi Gupta,&nbsp;Manjunath Nookala Krishnamurthy,&nbsp;Partha Sarathi Roy,&nbsp;Amal Chandra Kataki,&nbsp;Sudeep Gupta,&nbsp;Shankar Prinja","doi":"10.1007/s40258-024-00877-1","DOIUrl":"10.1007/s40258-024-00877-1","url":null,"abstract":"<div><h3>Background</h3><p>Survival outcomes for multiple myeloma have improved dramatically since the introduction of novel therapeutic agents. While these drugs are highly effective in improving survival outcomes and quality of life in patients with multiple myeloma, they come at a significant cost. We assessed the cost-effectiveness of bortezomib-based triplet or quadruplet drug regimens in isolation and followed by autologous hematopoietic stem cell transplantation (AHSCT) for the treatment of newly diagnosed multiple myeloma (NDMM) in the Indian context.</p><h3>Methods</h3><p>A Markov model was developed to assess the health and economic outcomes of novel drug regimens with and without AHSCT for the treatment of NDMM in India. We estimated the lifetime quality-adjusted life-years (QALYs) and costs in each scenario. The incremental cost-effectiveness ratios (ICERs) were computed and compared against the current willingness-to-pay threshold of a one-time per capita gross domestic product of ₹146,890 (US$1,927.70) for India. Parameter uncertainty was assessed through Monte Carlo probabilistic sensitivity analysis.</p><h3>Results</h3><p>Among seven treatment sequences, the VCd (bortezomib, cyclophosphamide, dexamethasone) alone arm has the lowest cost and health benefits as compared to four treatment sequences, namely VTd (bortezomib, thalidomide, dexamethasone) alone, VRd (bortezomib, lenalidomide, dexamethasone) alone, VRd plus AHSCT and DVRd (Daratumumab, bortezomib, lenalidomide, dexamethasone) plus AHSCT. It was found that VTd plus AHSCT and VCd plus AHSCT arms were extendedly dominated (ED) by combination of two alternative treatments. Among the five non-dominated strategies, VRd has a lowest incremental cost of ₹ 2,20,093 (US$2,888) per QALY gained compared to VTd alone followed by VRd plus AHSCT [₹3,14,530 (US$4,128) per QALY gained] in comparison to VRd alone. None of the novel treatment sequences were found to be cost-effective at the current WTP threshold of ₹1,46,890 (US$1,927.7).</p><h3>Conclusion</h3><p>At the current WTP threshold of one-time per capita GDP (₹ 146,890) of India, VRd alone and VRd plus AHSCT has 38.1% and 6.9% probability to be cost-effective, respectively. Reduction in current reimbursement rates of novel drugs, namely VRd, lenalidomide, and pomalidomide plus dexamethasone under national insurance program and societal cost of transplant by 50%, would make VRd plus AHSCT and VTd plus AHSCT cost-effective at an incremental cost of ₹40,671 (US$34) and ₹97,639 (US$1,281) per QALY gained, respectively<i>.</i></p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 4","pages":"569 - 582"},"PeriodicalIF":3.1,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048587","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 of Low-Value Imaging Worldwide: A Systematic Review","authors":"Elin Kjelle,&nbsp;Ingrid Øfsti Brandsæter,&nbsp;Eivind Richter Andersen,&nbsp;Bjørn Morten Hofmann","doi":"10.1007/s40258-024-00876-2","DOIUrl":"10.1007/s40258-024-00876-2","url":null,"abstract":"<div><h3>Background and Objective</h3><p>Imaging with low or no benefit for the patient undermines the quality of care and amounts to vast opportunity costs. More than 3.6 billion imaging examinations are performed annually, and about 20–50% of these are of low value. This study aimed to synthesize knowledge of the costs of low-value imaging worldwide.</p><h3>Methods</h3><p>This systematic review was based on the PRISMA statement. The database search was developed in Medline and further adapted to Embase-Ovid, Cochrane Library, and Scopus. Primary empirical studies assessing the costs of low-value diagnostic imaging were included if published between 2012 and March 2022. Studies designed as randomized controlled trials, non-randomized trials, cohort studies, cross-sectional studies, descriptive studies, cost analysis, cost-effectiveness analysis, and mixed-methods studies were eligible. The analysis was descriptive.</p><h3>Results</h3><p>Of 5,567 records identified, 106 were included. Most of the studies included were conducted in the USA (<i>n</i> = 76), and a hospital or medical center was the most common setting (<i>n</i> = 82). Thirty-eight of the included studies calculated the costs of multiple imaging modalities; in studies with only one imaging modality included, conventional radiography was the most common (<i>n</i> = 32). Aggregated costs for low-value examinations amounts to billions of dollars per year globally. Initiatives to reduce low-value imaging may reduce costs by up to 95% without harming patients.</p><h3>Conclusions</h3><p>This study is the first systematic review of the cost of low-value imaging worldwide, documenting a high potential for cost reduction. Given the universal challenges with resource allocation, the large amount used for low-value imaging represents a vast opportunity cost and offers great potential to improve the quality and efficiency of care.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 4","pages":"485 - 501"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139995345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#SharingHEOR: Developing Modern Media for Communication and Dissemination of Health Economics and Outcomes Research","authors":"Davene R. Wright,&nbsp;Mikaela Batista,&nbsp;Tim Wrightson","doi":"10.1007/s40258-023-00863-z","DOIUrl":"10.1007/s40258-023-00863-z","url":null,"abstract":"<div><p>Questions regarding the effectiveness and safety of health interventions and allocation of health care resources are frequently discussed in mainstream and social media. Additionally, government and foundation funders are increasingly mandating that results be disseminated to the lay public and patients may benefit from being able to digest scientific research regarding their health conditions. Therefore, it is important to widely disseminate and clearly communication health economics and outcomes research (HEOR) findings to a range of interested parties. Digital media features such as graphical or visual abstracts, infographics and videos are informative and add value to research articles by improving reader engagement with articles, potentially increasing their impact, and allowing results to be more widely disseminated. However, use of novel digital media for research dissemination has been relatively limited to date. In this article, we discuss the rationale for developing novel media to communicate and disseminate research findings and offer practical advice for doing so. We conclude by outlining a future agenda for research regarding HEOR communication and dissemination.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 4","pages":"447 - 455"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139995344","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":"The Impact of Raising Alcohol Taxes on Government Tax Revenue: Insights from Five European Countries","authors":"Jakob Manthey,&nbsp;Inese Gobiņa,&nbsp;Laura Isajeva,&nbsp;Jarosław Neneman,&nbsp;Rainer Reile,&nbsp;Mindaugas Štelemėkas,&nbsp;Jürgen Rehm","doi":"10.1007/s40258-024-00873-5","DOIUrl":"10.1007/s40258-024-00873-5","url":null,"abstract":"<div><h3>Background and Objective</h3><p>Reducing the affordability of alcoholic beverages by increasing alcohol excise taxation can lead to a reduction in alcohol consumption but the impact on government alcohol excise tax revenue is poorly understood. This study aimed to (a) describe cross-country tax revenue variations and (b) investigate how changes in taxation were related to changes in government tax revenue, using data from Estonia, Germany, Latvia, Lithuania and Poland.</p><h3>Methods</h3><p>For the population aged 15 years or older, we calculated the annual per capita alcohol excise tax revenue, total tax revenue, gross domestic product and alcohol consumption. In addition to descriptive analyses, joinpoint regressions were performed to identify whether changes in alcohol excise taxation were linked to changes in alcohol excise revenue since 1999.</p><h3>Results</h3><p>In 2022, the per capita alcohol excise tax revenue was lowest in Germany (€44.2) and highest in Estonia (€218.4). In all countries, the alcohol excise tax revenue was mostly determined by spirit sales (57–72% of total alcohol tax revenue). During 2010–20, inflation-adjusted per capita alcohol excise tax revenues have declined in Germany (− 22.9%), Poland (− 19.1%) and Estonia (− 4.2%) and increased in Latvia (+ 56.8%) and Lithuania (+ 49.3%). In periods of policy non-action, alcohol consumption and tax revenue showed similar trends, but tax level increases were accompanied by increased revenue and stagnant or decreased consumption.</p><h3>Conclusions</h3><p>Increasing alcohol taxation was not linked to decreased but increased government revenue. Policymakers can increase revenue and reduce alcohol consumption and harm by increasing alcohol taxes.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 3","pages":"363 - 374"},"PeriodicalIF":3.1,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40258-024-00873-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139925161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplified Methods for Modelling Dependent Parameters in Health Economic Evaluations: A Tutorial","authors":"Xuanqian Xie,&nbsp;Alexis K. Schaink,&nbsp;Sichen Liu,&nbsp;Myra Wang,&nbsp;Juan David Rios,&nbsp;Andrei Volodin","doi":"10.1007/s40258-024-00874-4","DOIUrl":"10.1007/s40258-024-00874-4","url":null,"abstract":"<div><h3>Background</h3><p>In health economic evaluations, model parameters are often dependent on other model parameters. Although methods exist to simulate multivariate normal (MVN) distribution data and estimate transition probabilities in Markov models while considering competing risks, they are technically challenging for health economic modellers to implement. This tutorial introduces easily implementable applications for handling dependent parameters in modelling.</p><h3>Methods</h3><p>Analytical proofs and proposed simplified methods for handling dependent parameters in typical health economic modelling scenarios are provided, and implementation of these methods are illustrated in seven examples along with the SAS and R code.</p><h3>Results</h3><p>Methods to quantify the covariance and correlation coefficients of correlated variables based on published summary statistics and generation of MVN distribution data are demonstrated using examples of physician visits data and cost component data. The use of univariate normal distribution data instead of MVN distribution data to capture population heterogeneity is illustrated based on the results from multiple regression models with linear predictors, and two examples are provided (linear fixed-effects model and Cox proportional hazards model). A conditional probability method is introduced to handle two or more state transitions in a single Markov model cycle and applied in examples of one- and two-way state transitions.</p><h3>Conclusions</h3><p>This tutorial proposes an extension of routinely used methods along with several examples. These simplified methods may be easily applied by health economic modellers with varied statistical backgrounds.</p></div>","PeriodicalId":8065,"journal":{"name":"Applied Health Economics and Health Policy","volume":"22 3","pages":"331 - 341"},"PeriodicalIF":3.1,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139904859","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}