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How policymakers value end-of-life treatments for rare and common diseases in China:evidence from a contingent valuation study 认领 引用
1
作者 Han Cheng Shan Jiang +6 位作者 Taoran Liu Boyang Li Shanquan Chen Ao Li Hao Chen Haiyin Wang Yuanyuan Gu 《Global Health Research and Policy》 CSCD 2025年第1期316-325,共10页
Background Understanding policymakers'value judgements in reimbursement decisions is essential for promoting equity and guiding informed healthcare decision-making.This study aimed to estimate and compare Chinese ... Background Understanding policymakers'value judgements in reimbursement decisions is essential for promoting equity and guiding informed healthcare decision-making.This study aimed to estimate and compare Chinese policymakers'willingness-to-pay(WTP)per quality-adjusted life year(QALY)specifically in end-of-life treatment scenarios involving life-threatening common and rare diseases.Methods We conducted a contingent valuation study employing single-bounded dichotomous-choice questions among 120 experts formally appointed by China's National Healthcare Security Administration to serve on the National Reimbursement Drug List Expert Committee in recent years.Participants evaluated hypothetical scenarios describing end-of-life treatments providing a one-QALY gain for patients with life-threatening common or rare diseases.Data were collected primarily through face-to-face interviews,supplemented by online responses when inperson meetings were impractical.Statistical analysis was performed using probit regression models,and t-tests were conducted to compare WTP values between scenarios.Results A total of 99 policymakers participated.Participants'WTP per QALY for end-of-life treatments in common disease scenarios ranged from CNY 78,031(0.98 times GDP per capita)to CNY 126,449(1.58 times GDP per capita).In contrast,WTP was significantly higher for rare diseases,ranging from CNY 183,392(2.29 times GDP per capita)to CNY 219,691(2.75 times GDP per capita).Analysis of individual characteristics revealed that female participants and those with expertise in pharmacoeconomics exhibited significantly higher WTP values in common disease scenarios(p<0.05),though these factors had varied effects in rare disease scenarios.Conclusions This study provides novel estimates of Chinese policymakers'WTP per QALY specifically in end-of-life contexts involving common and rare diseases,highlighting the significant impact of disease rarity on reimbursement decisions.These findings offer empirical support for adopting differentiated cost-effectiveness thresholds tailored to end-of-life treatments based on disease rarity in China. 展开更多
关键词 Willingness to pay Priority setting Healthcare resource allocation Contingent valuation Drug reimbursement Rare disease QALY Cost-effectiveness threshold
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Physicians'risk and time preferences and their willingness to detect and disclose genomic secondary findings:A multiple price list experiment 认领 引用
2
作者 Shan Jiang Haiyin Wang +4 位作者 Zhuo Chen Xiao Zang Yawen Jiang Zhongliang Zhou Yuanyuan Gu 《Pharmacoeconomics and Policy》 2025年第1期25-32,共8页
To quantify physicians'risk and time preferences and explore the association between the preferences and their willingness to detect and disclose secondary findings(SFs)derived from genome-scale sequencing.We desi... To quantify physicians'risk and time preferences and explore the association between the preferences and their willingness to detect and disclose secondary findings(SFs)derived from genome-scale sequencing.We designed a webbased survey incorporating a multiple price list(MPL)as the instrument for risk and time preference measurement.The estimation was under the expected utility theory(EUT)and rank dependent utility(RDU)frameworks,respectively.The isoelastic and power function utility models were applied.We received responses from 87 physicians,among whom 46 completed the questionnaire(a completion rate of 52.9%).We observed positive risk-aversion coefficients under EUT(0.33,95%CI 0.15-0.51)and RDU(0.51,95%CI 0.32-0.71),suggesting that physicians were generally risk-averse.Respondents were likely to underestimate probabilities of low to moderate levels,and slightly overestimate high-level probabilities.Physicians supporting the detection and disclosure of SFs had a larger risk-aversion coefficient and a smaller discounting parameter than the non-supporters,suggesting that they were more risk-averse and discounted future utility less.Assuming heterogeneous risk perception,we found respondents underestimated low/moderate risk and slightly overestimated high risk.This study indicates that physicians who are risk-averse and discount future utility slightly are willing to detect and return SFs.The findings contribute to the debate surrounding SF disclosure and generate implications for shared decision-making in clinical genome-scale sequencing. 展开更多
关键词 Risk preference Time preference Behavioural economics Secondary findings Genome sequencing
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The significance of smart healthcare for China’s healthcare reform 认领 引用
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作者 Chunlin Jin Yuyan Fu +2 位作者 Ru Wang Da He Haiyin Wang 《Intelligent Medicine》 EI CSCD 2025年第4期269-272,共4页
China’s healthcare reform faces significant hurdles like inefficient medical insurance fund utilization,imbalanced medical resource distribution,and limited innovation in biopharmaceuticals,necessitating smarter tech... China’s healthcare reform faces significant hurdles like inefficient medical insurance fund utilization,imbalanced medical resource distribution,and limited innovation in biopharmaceuticals,necessitating smarter technological interventions.This article assesses the impact of smart healthcare in China’s reform agenda.Innovative payment methods like Diagnosis-Related Group(DRG)and Disease Group Payment(DIP),bolstered by big data,have reduced patient burdens.Digitization in medical services has streamlined processes,improved patient experiences,and tackled regional resource disparities.Technologies such as artificial intelligence have accelerated drug development,boosting efficiency and precision.Yet,smart healthcare encounters challenges.To address these,the article suggests enhancing top-level design for technology standards,ensuring secure data sharing,advancing health technology assessments,and nurturing skilled personnel in smart technology. 展开更多
关键词 Smart healthcare Healthcare reform Artificial intelligence Big data
基于虚拟标准化临床生物化学实验室的诊断项目成本核算 认领 引用
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作者 邵文琦 赵瀛 +4 位作者 王海银 虞倩 王蓓丽 郭玮 潘柏申 《中华医院管理杂志》 CSCD 北大核心 2021年第9期788-792,共5页
目的基于虚拟标准化临床生物化学实验室对常规临床生物化学诊断项目进行成本核算。方法提取2019年1—6月上海市10家医院的临床生物化学实验室相关数据, 通过对3名卫生经济专家和上述医院检验科主任的访谈, 确定关键指标并构建虚拟标准... 目的基于虚拟标准化临床生物化学实验室对常规临床生物化学诊断项目进行成本核算。方法提取2019年1—6月上海市10家医院的临床生物化学实验室相关数据, 通过对3名卫生经济专家和上述医院检验科主任的访谈, 确定关键指标并构建虚拟标准化临床生物化学实验室模型。从物资损耗成本、人力成本和其他成本方面核算模型实验室的项目成本。根据检测方法原理对常规临床生物化学诊断项目进行聚类, 采用配对t检验比较同一聚类内项目的成本差异。结果采用速率法和干化学法检测丙氨酸氨基转移酶的成本分别为5.12元和11.63元;采用透射比浊法和散射比浊法检测免疫球蛋白G的成本分别为20.00元和22.26元。对214个常规临床生物化学诊断项目进行聚类分析, 其中的202项被归为42个聚类, 其日均检测量占总检测量的91.7%(4 493/4 900)。对丙氨酸氨基转移酶(速率法)、天门冬氨酸氨基转移酶(速率法)、胆固醇(酶法)和尿酸(酶法)这4种基于酶学的同一聚类实验室诊断项目进行成本核算, 结果分别为5.12元、5.10元、5.24元和5.14元, 其差异无统计学意义(P>0.05)。结论本研究构建的临床生物化学实验室诊断项目成本核算方法纳入了人力成本核算, 体现出医务人员的技术劳务价值, 并可基于项目聚类核算成本, 可为医疗服务价格制定和医院运营管理提供参考。 展开更多
关键词 财务管理 医院 成本核算 诊断项目 临床生物化学实验室
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