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Patikorn C, Tan CJ, Cho JY, Khuntha S, Ha NT, Noviyani R, Gloria MAJ, Avanceña ALV, Youngkong S, Shimamoto K, Chaiyakunapruk N. Role of Health Equity in Health Technology Assessment Processes: A Landscape Analysis of 13 Health Systems in Asia. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2025; 28:582-590. [PMID: 39922297 DOI: 10.1016/j.jval.2025.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 12/19/2024] [Accepted: 01/20/2025] [Indexed: 02/10/2025]
Abstract
OBJECTIVES This landscape analysis aimed to summarize the role of health equity in the health technology assessment (HTA) process (topic nomination, topic prioritization, assessment, appraisal, and decision making) in Asia. METHODS A comprehensive literature review was conducted, followed by in-depth interviews with key informants. Content analysis was performed to summarize the role of health equity in HTA in 13 health systems in Asia, including Brunei Darussalam, Cambodia, China, Indonesia, Japan, Malaysia, Myanmar, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam. RESULTS Health equity was reported to be considered in most health systems' HTA processes, except for Cambodia and Myanmar, which do not have an established HTA process. Interviews revealed that health equity has been more frequently considered to address the unmet medical needs of specific diseases (eg, high disease burden or severity, rare diseases, cancer, and diseases affecting children and the elderly) in Brunei Darussalam, China, Japan, Malaysia, Singapore, South Korea, Taiwan, Thailand, and Vietnam or inequities in socially disadvantaged groups (eg, socioeconomic status and geographical location) in Indonesia and the Philippines. Equity-informative economic evaluation was still in the early stages, with only 3 health systems reporting their use. CONCLUSIONS Health equity is considered in the HTA process in most Asian health systems. However, quantitative evaluation of health equity impact is still in its infancy because few health systems have just begun to perform equity-informative economic evaluations.
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Affiliation(s)
- Chanthawat Patikorn
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand; Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Chia Jie Tan
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Jeong-Yeon Cho
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA; School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Sarayuth Khuntha
- Mahidol University Health Technology Assessment Program, Mahidol University, Bangkok, Thailand
| | - Nguyen Thi Ha
- Faculty of Pharmacy, University of Health Sciences, Vietnam National University Ho Chi Minh City, Vietnam
| | - Rini Noviyani
- Mahidol University Health Technology Assessment Program, Mahidol University, Bangkok, Thailand; Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Udayana University, Bali, Indonesia
| | - Mac Ardy J Gloria
- Mahidol University Health Technology Assessment Program, Mahidol University, Bangkok, Thailand; Department of Clinical, Social and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila, Manila, Philippines
| | - Anton L V Avanceña
- Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA; Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Sitaporn Youngkong
- Social and Administrative Pharmacy Division, Department of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Kyoko Shimamoto
- Keio Global Research Institute, Keio University, Tokyo, Japan
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA; IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA.
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Zhang M, Yang Y, Bao Y, Kimber M, Levine M, Xie F. Scoring the Value Assessment Framework for China: A Factorial Survey. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:330-339. [PMID: 38135215 DOI: 10.1016/j.jval.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/09/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES This study aimed to develop the scoring functions for the recently developed value assessment framework (VAF) for China, which comprises 12 attributes. METHODS We implemented a factorial survey among Chinese healthcare stakeholders from July to September 2022. A total of 240 hypothetical drug value profiles described by the VAF were grouped into 60 blocks and randomly assigned to respondents. Each respondent was assigned with 1 block, each presented in 3 disease scenarios of different levels of severity. For each profile, respondents were asked to assess the drug's value on a scale from 0 (lowest) to 10 (highest) and make 1 of the 3 insurance recommendations: cover, to be negotiated for coverage, or reject. Linear and logistic mixed-effects models were used to develop scoring functions for aggregating the value attributes. RESULTS A total of 365 respondents participated in the survey. 3968 responses from 331 respondents were included in the analysis. Most of the included respondents were under 45 (n = 256, 77.3%), females (n = 208, 62.8%), living in urban areas (n = 296, 89.4%), and with a bachelor's degree or higher (n = 303, 91.5%). Health benefits and safety carried more weights than other attributes in the scoring functions across disease scenarios. The value and probability of entering negotiation or receiving insurance coverage for the attribute profiles for severe/critical disease were higher than for mild/moderate disease. CONCLUSIONS The scoring functions of the VAF can be used to assess the value of a drug and its probability of entering negotiation or receiving insurance coverage in China.
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Affiliation(s)
- Mengmeng Zhang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Yi Yang
- School of Public Health, Fudan University, Shanghai, China; National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yun Bao
- Institute of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Melissa Kimber
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Mitchell Levine
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Division of Clinical Pharmacology and Toxicology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
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