Health Decision
https://www.hksmp.com/journals/hd
<p>Health Decision Making, to analyse issues related to health economics, health management or health policy through quantitative or qualitative methods to help decision-making.</p>en-USoffice@hdjournal.com (Editorial Office)stanleyzhang@hdjournal.com (Stanley Zhang)Thu, 05 Jan 2023 10:56:05 +0800OJS 3.3.0.7http://blogs.law.harvard.edu/tech/rss60Traditional Chinese medicine in treating corona virus disease 2019: A systematic review and cost-effectiveness analysis
https://www.hksmp.com/journals/hd/article/view/287
<p><strong>ABSTRACT</strong></p> <p><strong>Background: </strong>Currently, corona virus disease 2019 (COVID-19) has infected 633,601,048 people worldwide according to World Health Organization, which leads to huge disease burden. A considerable number of trials of traditional Chinese medicine (TCM) have been carried out and have shown the efficacy of TCM in the treatment of COVID-19, but their cost-effectiveness has not been studied, especially in China. Therefore, we plan to perform a systematic review and cost-effectiveness analysis to explore the cost-effectiveness of using TCM in treating COVID-19.</p> <p><strong>Methods</strong><strong>: </strong>A systematic review based on previously published secondary data from randomized controlled trials and observational studies which included TCM as one of the interventions for patients with COVID-19 will be performed. Patients with COVID-19 will be classified into five specific groups (patients without diagnosis; patients with mild, moderate, severe and critical symptoms). TCM versus western medicine on both effectiveness outcomes(cure rate and survival rate) and utility outcome(quality-adjusted life years) will be evaluated. A decision tree model will be established taking the perspective of Chinese health care system since the costs were paid by the Chinese government. Cumulative costs, Qalys, and incremental cost-effectiveness ratio will be selected as the outcome indicator. Sensitivity analysis will also be conducted to evaluate the impact of parameter uncertainty on the base-case analyses results. We will present results at various willingness-to-pay thresholds using a cost-effectiveness acceptability curve.</p> <p><strong>Discussion</strong> We hope to demonstrate the cost-effectiveness of TCM, see an improvement in the patients' quality of life, achieve a improvement in the cure rate and survival rate of COVID-19. If TCM is cost-effectiveness, it could be applied to clinical practice decision making.</p> <p><strong>Ethics and dissemination</strong>: Ethics approval is not required for the current study. Because the data used in this study is just the re-use of data which are already in the public domain. The results will be disseminated to general public, clinicians, academics and policy makers.</p> <p><strong>Registration numbe</strong><strong>r</strong>: CRD42021228887</p> <p><strong>Keywords: </strong>Traditional Chinese medicine; Corona Virus Disease 2019; decision tree model; systematic review; cost-effectiveness analysis</p>Taihang Shao, Ke Wang, Xing Liao, Wenxi Tang
Copyright (c) 2023 Health Decision
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https://www.hksmp.com/journals/hd/article/view/287Fri, 17 Mar 2023 00:00:00 +0800Cost effectiveness analysis of blonanserin versus ziprasidone as first-line treatment for patients with schizophrenia in China
https://www.hksmp.com/journals/hd/article/view/362
<p><strong>Background and Objectives:</strong> The aim of the study is to evaluate the cost-effectiveness of blonanserin compared with ziprasidone as first-line treatment for patients with schizophrenia in China. <strong>Methods:</strong> A 10-state Markov model was built to assess the long-term cost-effectiveness of blonanserin from China health care system perspective. A time horizon of 10 years with monthly cycle was chosen. Patients with schizophrenia will receive blonanserin or ziprasidone as first-line treatment and could switch to olanzapine or clozapine as second-line or third-line treatment when symptoms relapse happens. Efficacy and safety data were derived from network meta-analysis. Probabilities of experience recurrences were derived from a retrospective cohort study. The costs were obtained from real world data and local published resources. Costs and outcomes were both discounted at 5%. Sensitivity analysis were conducted to verify the robustness of the results. <strong>Results: </strong>Blonanserin generated 4.30 quality-adjusted life-years (QALYs) with cost of Chinese Yuan (CNY) 167,011, whereas ziprasidone generated 4.28 QALYs with cost of CNY 173,575. Compared with ziprasidone, blonanserin was seen as the dominant treatment. One-way sensitivity analysis demonstrated the robustness of the base case results. Probabilistic sensitivity analysis showed that blonanserin was a cost-effective strategy in more than 70% simulations under the local threshold compared with ziprasidone. <strong>Conclusions:</strong> Compared with ziprasidone, blonanserin is cost-effective as first-line treatment for patients with schizophrenia in China.</p>Xin Guan, Luying Wang, Yang Cao, Fenghao Shi; He Xu; Jie Ding, Meiyu Wu, Hongchao Li
Copyright (c) 2023 Health Decision
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https://www.hksmp.com/journals/hd/article/view/362Thu, 31 Aug 2023 00:00:00 +0800Age priority in continuous coronavirus disease 2019 booster doses under China's new policy of free-will nucleic acid test: A dynamic model-based effectiveness and cost-effectiveness analysis
https://www.hksmp.com/journals/hd/article/view/294
<p><strong>Background</strong>: The initial mass vaccination's effectiveness has diminished, necessitating accelerated immunization coverage scaling. China has shifted nucleic acid testing from large-scale to voluntary. This study assesses the effectiveness and cost-effectiveness of different booster vaccination strategies in China. <strong>Methods</strong>: A dynamic transmission model divided the population into three groups: 0-19, 20-59, and 60+ years. We evaluated the effectiveness and cost-effectiveness of three vaccination strategies based on previous studies and public databases. Three scenarios were modeled and compared to no-continuation-vaccination to calculate averted diseases, deaths, and net benefits. One-way sensitivity analysis and probabilistic sensitivity analysis assessed findings' stability. <strong>Results</strong>: COVID-19 vaccination had significant health benefits compared to no continuing vaccination. Strategy II (prioritizing vaccinated 20-59-year-olds, then vaccinated 60+ individuals, and finally 0-19-year-olds) was the most cost-effective. Strategy I (prioritizing unvaccinated 60+ individuals, then 20-59, and finally 0-19) prevented the most deaths. Strategy II was the most cost-effective, with a total cost of 93,995,223,462 USD and the highest net benefit of 3,054,475,908,551,960 USD. Strategy II resulted in the highest number of avoided cases across categories, including infected, asymptomatic, mild/moderate, severe, and critical cases. Each strategy's effects on preventing new cases and critical illness were comparable. Sensitivity analyses confirmed the results' reliability. <strong>Conclusion</strong>: Prioritizing vaccinated 20-59-year-olds, then vaccinated 60+ individuals, and finally 0-19-year-olds was the most effective prevention strategy. The vaccination strategy should be tailored to the pandemic situation and available medical resources for maximum health gains.</p>Dachuang Zhou, Taihang Shao, Hanqiao Shao, Yusi Tu, Mingye Zhao, Kejia Zhou, Ke Wang, Xiangyan Tang, Zeyao Liu, Yilan Xing, Daniel C Malone, Wenxi Tang
Copyright (c) 2023 Health Decision
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https://www.hksmp.com/journals/hd/article/view/294Fri, 26 May 2023 00:00:00 +0800Different vaccination strategies for preventing coronavirus disease 2019 in Kenya: A dynamic modelling study of health impact and cost-effectiveness
https://www.hksmp.com/journals/hd/article/view/295
<p><strong>Background: </strong>Vaccination can significantly reduce the health impact and economic burden of coronavirus disease 2019 (COVID-19), but vaccination levels for COVID-19 in most African countries lag far behind global averages. We assessed the cost-effectiveness of different COVID-19 vaccination strategies in Kenya and determined the optimal vaccination strategy. <strong>Methods: </strong>Using a dynamic transmission model, we divided the population into three groups: 0-18 years, 19-58 years and 58+ years. We assessed the effectiveness and cost-effectiveness of three vaccination strategies at different numbers of daily vaccinations based on previous studies and public databases. Nine scenarios were modeled and compared to no-continuation-vaccination to calculate the number of averted diseases, averted deaths, and net benefits of different vaccination strategies. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to assess the stability of our findings. <strong>Results:</strong> Compared to no-continuation-vaccination for various vaccination scenarios, all vaccination strategies were found to be effective and cost-saving. The incremental net benefit ranged from 0.235 billion USD to 2.305 billion USD, and prioritizing vaccination boosters for individuals aged 19-58 was identified as the most cost-effective option. On the other hand, prioritizing vaccination for the unvaccinated population aged 58 and above could potentially reduce COVID-19 related deaths by 1.59%-56.60%, which was the most effective approach in avoiding cause-specific deaths. However, all vaccination strategies were found to be ineffective in controlling the infection trend when compared to no intervention under different vaccination scenarios, with only 474,318-5,306,865 infections potentially being prevented. <strong>Conclusion: </strong>Timely and widespread vaccination against COVID-19 in Kenya is effective and cost-effective, a specific vaccination strategy should be selected based on decision-making needs. Priority vaccination for the elderly without vaccination may be more cost-effective compared with other vaccination strategies.</p>Dachuang Zhou, Hanqiao Shao, Yusi Tu, Taihang Shao, Mingye Zhao, Kejia Zhou, Ke Wang, Xiangyan Tang, Yilan Xing, Zeyao Liu, Daniel C Malone, Wenxi Tang
Copyright (c) 2023 Health Decision
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https://www.hksmp.com/journals/hd/article/view/295Wed, 26 Apr 2023 00:00:00 +0800A Erratum on Cost effectiveness analysis of blonanserin versus ziprasidone as first-line treatment for patients with schizophrenia in China
https://www.hksmp.com/journals/hd/article/view/498
Xin Guan, Luying Wang, Yang Cao, Fenghao Shi; He Xu; Jie Ding, Meiyu Wu, Hongchao Li
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https://www.hksmp.com/journals/hd/article/view/498Fri, 24 Nov 2023 00:00:00 +0800Improving evidence and outcomes in health decision-making in Asia-Pacific
https://www.hksmp.com/journals/hd/article/view/161
Aixia Ma
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https://www.hksmp.com/journals/hd/article/view/161Thu, 05 Jan 2023 00:00:00 +0800Traditional Chinese medicine provides new ideas for the treatment of coronavirus disease 2019
https://www.hksmp.com/journals/hd/article/view/285
Jie Guan, Yuxuan Hu, Wenying Yu
Copyright (c) 2023 Health Decision
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https://www.hksmp.com/journals/hd/article/view/285Fri, 10 Feb 2023 00:00:00 +0800