Health Policy and Technology最新文献

{"title":"Health technology assessment of nailfold capillaroscopy and digital retina imaging in diabetes screening","authors":"Vinaytosh Mishra ,&nbsp;Zahiruddin Quazi Syed","doi":"10.1016/j.hlpt.2024.100938","DOIUrl":"10.1016/j.hlpt.2024.100938","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to identify the criteria for the evaluation of medical technologies in diabetes screening and then perform health technology assessment (HTA) for two technologies: digital retina imaging (DRI) and Nailfold Capillaroscopy (NFC).</div></div><div><h3>Methods</h3><div>A multicriteria decision-making tool measuring attractiveness using a categorical-based evaluation technique (MACBETH) was used to calculate and compare alternatives. A focus group of ten decision-makers with more than ten years of experience in health technology was used for the decision-making. The Delphi Method was used to get a consensus about comparing criteria and alternatives to these criteria. The sampling method used in the study was the nonprobability purposive sampling method.</div></div><div><h3>Results</h3><div>The study concluded that clinical efficacy (0.42) is the most important criterion for evaluating medical technologies, followed by cost-effectiveness (0.27). At the same time, ethical considerations were found to be less important (0.03). The sensitivity analysis concluded that the decision is sensitive to clinical efficacy and cost-effectiveness changes. The study found that none of the alternatives dominates others as an option for early detection of diabetes through vascular changes.</div></div><div><h3>Limitations</h3><div>This study primarily uses systemic literature review methods to identify criteria for evaluating alternatives. There may be additional criteria for evaluation.</div></div><div><h3>Conclusion</h3><div>This study provides an approach for a multicriteria comparison of medical devices. The study findings are useful for public health professionals and health policymakers.</div></div><div><h3>Plain language summary</h3><div>This study assesses nailfold capillaroscopy (NFC) as a substitute for digital retina imaging (DRI) in diabetes screening using the MACBETH multicriteria decision-making tool. The research identifies five key evaluation criteria: clinical efficacy, cost-effectiveness, patient needs, user safety, and ethical considerations. A focus group of experienced health technology decision-makers was used to compare NFC and DRI. Results indicate that clinical efficacy and cost-effectiveness are the most critical factors, with NFC showing potential but not significantly outperforming DRI. Sensitivity analyses highlight the need for further research to validate NFC as an effective diabetes screening tool.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 1","pages":"Article 100938"},"PeriodicalIF":3.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating mobile health interventions for HIV patients in Nigeria: Healthcare policy implications from a simulation study","authors":"Eren Demir ,&nbsp;Usame Yakutcan ,&nbsp;Adekunle Olatayo Adeoti ,&nbsp;Christian Isichei ,&nbsp;Shola Adeyemi","doi":"10.1016/j.hlpt.2024.100937","DOIUrl":"10.1016/j.hlpt.2024.100937","url":null,"abstract":"<div><h3>Objectives</h3><div>People living with HIV/AIDS (PLWHA) benefit from mobile health (mHealth) technologies through self-managing and monitoring their disease with enhanced patient experience and health outcomes. However, the efficiency and cost-effectiveness of these interventions are yet to be studied. The study aims to assess the impact of mHealth on operational and cost metrics relevant to PLWHA and HIV service delivery.</div></div><div><h3>Data Sources</h3><div>Data were a mixture of primary and secondary data from the hospital setting, experts’ opinions, reports, and the literature.</div></div><div><h3>Method</h3><div>Using a web-based simulation platform, SmartHIV Manager™, for the management of HIV services, we tested scenarios based on four possible reductions in the number of clinic visits and four groups of PLWHA who can be offered a mobile device free of charge (16 scenarios in total). The study was conducted in collaboration with Faith Alive Foundation Hospital (Nigeria) using a mHealth app (BSmart Chart).</div></div><div><h3>Results</h3><div>In the worst-case scenario, the hospital anticipates a 14 % decrease in the number of visits from stable patients, nine fewer doctors to operate their service, and a 3 % savings in total cost after accounting for mHealth intervention expenses and mobile phone acquisition. With the service currently running at 161 % doctor capacity, this intervention alleviates staff pressure and ensures quality care.</div></div><div><h3>Conclusion</h3><div>The study shows significant system efficiency gains, fewer visits, better health outcomes, economic benefits for stable patients, and increased capacity. These findings apply to most HIV services worldwide, especially in times of limited resources.</div></div><div><h3>Public Interest Summary</h3><div>Mobile health (mHealth) technologies support people living with HIV/AIDS by helping them manage their health and receive remote monitoring. This study examines the impact of mHealth apps on the costs and operations of HIV services. Conducted in a rural HIV setting in Nigeria, where many patients face financial challenges, the research used a simulation-based decision support tool (known as SmartHIV Manager) to test the scenario of providing free mobile devices and reducing clinic visits for stable patients. Results indicated that this approach could reduce patient visits and healthcare costs while easing the workload of overburdened doctors. Globally, introducing mHealth apps could be impactful, given the constraints of limited healthcare staff and budgets.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 6","pages":"Article 100937"},"PeriodicalIF":3.4,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Market access regulations for mHealth applications in Germany, Austria and Switzerland: A Review","authors":"Kira Jürgens ,&nbsp;Agnieszka Raddatz ,&nbsp;Frank Tausendfreund ,&nbsp;Timo Clemens","doi":"10.1016/j.hlpt.2024.100934","DOIUrl":"10.1016/j.hlpt.2024.100934","url":null,"abstract":"<div><div>Market access regulations for mobile health applications are divergent across countries. A uniform legal framework for mobile health applications is currently lacking, therefore, this review compares the requirements and processes for mobile health applications in Germany, Austria, and Switzerland. The review used a combined search in domestic law databases, PubMed and institutional websites to synthesise the available information for market access. The investigated countries have similar ongoing digital health projects; therefore, mandatory enforcement procedures to encourage the use of mobile health applications are implemented. Mobile health applications must meet different additional domestic requirements including increased data security and interoperability with existing telematic structures which are common in all countries. A formal process of certification for mobile health applications must be completed in Germany. In Austria, there are no formal processes, and in Switzerland, healthcare facilities must provide certification. However, in all three countries regulatory steps involve: the Ministry of Health, a Medical Device agency and telemedicine/digital health expert center. Manufacturers need to familiarise themselves with diverse regulatory and legal requirements early in the product development process. In the future, new cooperation approaches between industry, policymakers and MedTech associations can help to fulfil requirements on time and thus advance market entry for digitalised health products in the healthcare sector.</div></div><div><h3>Public interest summary</h3><div>Rules for placing mobile health applications on the market differ in Germany, Austria, and Switzerland. Hence, manufacturers of such products must understand the requirements in each of the country separately. The study has examined these rules and compared them. Mobile health applications in these countries must meet extra requirements like better data security to protect users privacy and the ability of those products to “communicate” and exchange information with existing IT systems. In Germany, there is a formal process for approval of these products. In Austria, there is not a formal process but mobile health applications need to be evaluated according to set criteria, and in Switzerland, healthcare facilities must provide approval themselves. In all three countries, the government's Ministry of Health, a Medical Device agency, and a center of experts in digital health play a role in the regulations. Manufacturers need to understand these different rules early on when they are developing their products.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 5","pages":"Article 100934"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating progress towards implementation of the European HTA Regulation: Insights generated from the European Access Academy's multi-stakeholder survey","authors":"Francine Brinkhuis ,&nbsp;Jörg Ruof ,&nbsp;Hendrika van den Ham ,&nbsp;Fabrizio Gianfrate ,&nbsp;Valentina Strammiello ,&nbsp;Michael Berntgen ,&nbsp;Mira Pavlovic ,&nbsp;Peter Mol ,&nbsp;Jürgen Wasem ,&nbsp;Walter Van Dyck ,&nbsp;Antonella Cardone ,&nbsp;Christian Dierks ,&nbsp;Anja Schiel ,&nbsp;Oriol Solà-Morales ,&nbsp;Wim Goettsch ,&nbsp;Elaine Julian","doi":"10.1016/j.hlpt.2024.100930","DOIUrl":"10.1016/j.hlpt.2024.100930","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;We conducted a multi-stakeholder survey to assess stakeholders' perceptions of the progress made towards the implementation of the European Regulation on Health Technology Assessment (EU HTA R) and to identify and prioritize the remaining challenges for implementation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Using two iterative Delphi cycles, an exploratory, semi-quantitative survey was developed to identify how stakeholders 1) experienced preparatory activities of the Regulation, and 2) prioritized remaining challenges for successful implementation. The survey was distributed among the network of the European Access Academy and via social media to ensure coverage of key stakeholders. Descriptive analyses were performed on quantitative response items, and relative importance was calculated for ranking items. Free-text responses supplemented participants' answers to quantitative questions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;N = 61 responses were received from N = 15 countries including Global/ EU-wide institutions (Patients and Patients’ representatives: 7; Clinicians’ representatives: 5; Regulators: 3; Health Technology Developers (HTDs): 20; HTA bodies: 10; Payers: 7; Policy Makers: 2; Academic representatives: 7). The majority of respondents were aware of preparatory activities, with 74 % (N = 45) observing the drafting of Guidance Documents and 64 % (N = 39) noting the establishment of the Coordination Group. Respondents ranked the success of preparatory activities neutral with a slight tendency towards a positive ranking. Key challenges were Member States' readiness for Joint Clinical Assessments, HTA capacity/ capability constraints, and the applicability/ feasibility of the methodological framework.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study identified the key remaining challenges for the successful establishment of the EU HTA process. Key findings emphasize the readiness of national systems and procedures as pivotal factors. Balancing operational efficiency with strategic objectives, including the development of a European Value Framework, is imperative for harnessing the full potential of the joint HTA process and enhancing patient access to innovative technologies on a pan-European scale.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Public interest summary&lt;/h3&gt;&lt;div&gt;In January 2022, the European Union (EU) adopted the European Regulation on Health Technology Assessment (HTA). By harmonizing HTA practices and promoting collaboration across Member States, the joint procedure as set out in the regulation aims to improve efficient use of resources and ensure long-term sustainability of EU-wide HTA cooperation. Close to reaching the half-way mark of the preparation phase in mid-2023, we conducted a multi-stakeholder survey to assess perceptions of the progress made towards implementation of a joint procedure and to prioritize remaining challenges. The responses indicated a neutral to positive perception of the preparatory activitie","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 5","pages":"Article 100930"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practices and systems employed by health professionals toward protection and confidentiality of patient health records in Ghana","authors":"Eric Gotah,&nbsp;Emmanuel Adjei,&nbsp;Philip Kwaku Kankam,&nbsp;Monica Mensah Danquah","doi":"10.1016/j.hlpt.2024.100933","DOIUrl":"10.1016/j.hlpt.2024.100933","url":null,"abstract":"<div><h3>Objectives</h3><div>Health information relies on a patient's sensory perceptions as well as objective assessments, diagnoses, and test findings. Ghana's current laws governing the confidentiality of patient health data seems a little pertinent in spite of ongoing conversations on the significance of patient health information and the necessity to protect patient information from improper disclosure. The study therefore investigated the extent of patient confidentiality in Ghana by looking into the guidelines, regulations, and rules that govern patient records.</div></div><div><h3>Methods</h3><div>The interpretive, phenomenological, and narrative methodologies used in qualitative research were employed to study the phenomenon. Twenty (20) participants were interviewed in a semi-structured manner to gather the data needed for the analysis comprising of Doctors, Nurses, Administrative staff, Record Officers, and Information Communication Technology (ICT0 Technicians of five Departments in La General Hospital. The Activity Theory was used as a theoretical foundation for the study</div></div><div><h3>Conclusions</h3><div>The study revealed that healthcare professionals uphold the moral standards relating to patient confidentiality and trust. Again, the findings of the study showed that medical records are safely stored through the use of Electronic Health Record system in the hospital in a manner that wouldn't compromise patient confidentiality. However, the results establishes that health care workers can potentially serve as a conduit for the leak or breach of patient information through negligence and unprofessional practices.</div></div><div><h3>Public interest statement</h3><div>The study investigated systems and practices that are employed by health workers in Ghana to ensure that patient health records are safeguarded in order to build patients confidence in how their health records are protected. Health workers were interviewed in this study and the findings of the study show that there are practices and systems put in place to safeguard patient health records in the hospitals. Although, it was established that EHR systems help in safeguarding patient health records, the study recommends the need for users of the Health Electronic Records to be fully involved in the implementation process and strict enforcement of policies regarding the use of the EHR system to help prevent negligence and unprofessional application of the system.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 5","pages":"Article 100933"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 esophageal varices screening strategies of cirrhotic patients with portal hypertension","authors":"Claire Cavalin ,&nbsp;Solène Schirr-Bonnans ,&nbsp;Astrid Darsonval ,&nbsp;Valéry-Pierre Riche ,&nbsp;Solène Brunet-Houdard ,&nbsp;Fanny Monmousseau ,&nbsp;Emmanuel Nowak ,&nbsp;Geneviève Perrocheau ,&nbsp;Nathalie Andreu ,&nbsp;Sophie Tollec ,&nbsp;Myriam Le Goff Pronost ,&nbsp;Emma Bajeux ,&nbsp;Sylvie Sacher-Huvelin","doi":"10.1016/j.hlpt.2024.100925","DOIUrl":"10.1016/j.hlpt.2024.100925","url":null,"abstract":"<div><h3>Objectives</h3><div>In France, screening for esophageal varices (EVs) in cirrhotic patients with portal hypertension (PH) is performed by esophagogastroduodenoscopy (EGD). Though proven effective, EGD screening may be unpleasant for some patients. Our study sought to compare the cost-effectiveness of PillCam (Medtronic, Minneapolis, USA) esophageal capsule endoscopy (ECE), a less invasive test, versus EGD, for EV screening, from the perspective of the French national health system (NHS). In secondary objectives we compared the cost-effectiveness of ECE versus no screening for patients not compliant with EGD screening, and the cost-effectiveness of a screening strategy (ECE or EGD) versus no screening strategy at all.</div></div><div><h3>Methods</h3><div>We constructed a Markov model with data from the literature, applying it to two simulated cohorts of adult patients with cirrhosis and PH not previously screened for EVs. These patients were divided into EGD and ECE screening arms and tracked over a virtual 10-year period. Cost-effectiveness was defined as cost (in euros) per quality-adjusted life year (QALY).</div></div><div><h3>Results</h3><div>In the base-case analysis, ECE is more expensive than EGD (€3,606 vs. €3,030) and less effective by 0.0098 QALY (5.2099 vs. 5.2197 QALYs). Probabilistic sensitivity analysis shows that ECE has only a 2.1 % probability of being cost-effective at willingness-to-pay (WTP) of €30,000/QALY.</div></div><div><h3>Conclusions</h3><div>Although patient compliance is apparently higher with ECE, it is not cost-effective at a WTP of €30,000/QALY and should not be considered in all patients with PH. Its cost-effectiveness should be reevaluated in the event of patient refusal of EGD follow-up.</div></div><div><h3>Public Interest Summary</h3><div>Esophagogastroduodenoscopy (EGD) is gold standard to screen cirrhotic patients with portal hypertension for esophageal varices, but its unpleasantness lowers compliance. We evaluated the cost-effectiveness of a more acceptable alternative for patients: the esophageal capsule endoscopy (ECE).</div><div>Our results show that screening by ECE is more expensive and less effective than by EGD from the perspective of the French national health system. It cannot be used as an alternative for all patients suffering from PH in France. Further investigations could be conducted to assess the effectiveness of ECE for the sub population of patients with PH who are totally refractory to EGD and may suffer from inadequate follow-up due to lack of screening.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 5","pages":"Article 100925"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 emerging technologies on healthcare needs of older people","authors":"Tal Soffer ,&nbsp;Yoel Raban ,&nbsp;Sigalit Warshawski ,&nbsp;Sivia Barnoy","doi":"10.1016/j.hlpt.2024.100935","DOIUrl":"10.1016/j.hlpt.2024.100935","url":null,"abstract":"<div><h3>Background</h3><div>The global elderly population is rapidly increasing resulting in a higher burden on healthcare systems. Emerging technologies may contribute to counteracting the shortage of healthcare workers and to assist the elderly in both healthcare settings and the community.</div></div><div><h3>Objective</h3><div>The study aimed to identify emerging technologies that may have a significant impact on the healthcare and social needs of the elderly, to assess their time to market, and to recommend policy measures intended to overcome entry barriers.</div></div><div><h3>Methods</h3><div>A foresight study was conducted, including horizon scanning, interviews, and a survey of 76 participants who were experts from the fields of health and technology in Europe and Israel.</div></div><div><h3>Results</h3><div>Thirteen emerging technologies were identified and five main areas of needs for the elderly were recognized: mobility, cognition, self-care, social life, and access to healthcare. All the emerging technologies were shown to have a high impact on healthcare needs for the elderly. The most influencing technologies were wearables, artificial intelligence apps and fall prevention devices. The most influential area of need was self-care, while the lowest area was social life. The forecast was that most technologies will reach the market as early as 2024 and will continue to evolve and impact healthcare. The significant barriers were forecasted to be high cost, lack of ease of use, and training.</div></div><div><h3>Conclusions</h3><div>The important policy measures are to increase usability and the availability of solutions, public funding, and training.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 5","pages":"Article 100935"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicians’ perspective of the opioid analgesic stewardship in acute pain clinical care standard","authors":"Chelsea Dutkiewicz ,&nbsp;Shania Liu ,&nbsp;Asad Patanwala ,&nbsp;Andrew J McLachlan ,&nbsp;Jennifer Stevens ,&nbsp;Kok Eng Khor ,&nbsp;Bernadette Bugeja ,&nbsp;David Begley ,&nbsp;Ian Fong ,&nbsp;Katelyn Jauregui ,&nbsp;Jonathan Penm","doi":"10.1016/j.hlpt.2024.100936","DOIUrl":"10.1016/j.hlpt.2024.100936","url":null,"abstract":"<div><h3>Objectives</h3><div>Opioid analgesics are high-risk medicines, widely used in hospitals to manage pain. To improve the use of opioids in Australia, The Australian Commission on Safety and Quality in Health Care released the first national Opioid Analgesic Stewardship in Acute Pain Clinical Care Standard (Opioid Stewardship Standard). The objective of this study was to explore clinicians’ perspectives of the implementation of the Opioid Stewardship Standard to understand factors that may impact this process.</div></div><div><h3>Methods</h3><div>Qualitative one-on-one interviews were conducted with clinicians, including doctors, pharmacists, nurses, and patient safety officers. The interview guide was developed based on the Consolidated Framework of Implementation Research. Interview transcriptions were thematically analyzed using an inductive approach to identify common themes.</div></div><div><h3>Results</h3><div>In total, 32 clinicians were interviewed, including 10 doctors, 10 pharmacists, and 12 nurses from 26 sites across Australia. Themes identified included: (i) Organizational priorities, (ii) organizational capacity for implementation, (iii) changing prescribing practices, and (iv) the Opioid Stewardship Standard.</div></div><div><h3>Conclusions</h3><div>Clinicians’ perceptions were categorized into four themes regarding the implementation of the Opioid Stewardship Standard. Key findings from this study included the importance of local data to increase organizational prioritization, availability of resources and staffing to increase organizational capacity for implementation to implement the Opioid Stewardship Standard. Future studies should evaluate the impact of such strategies on implementation.</div></div><div><h3>Lay summary</h3><div>Health professionals need more support from the health system to deliver health care that aligns with policies such as the Opioid Stewardship Standard. Organisations within the health system should consider providing support such as staffing to meet these needs.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 5","pages":"Article 100936"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An empirical study looking at the potential impact of increasing cost-effectiveness threshold on reimbursement decisions in Thailand","authors":"Wanrudee Isaranuwatchai ,&nbsp;Yi Wang ,&nbsp;Budsadee Soboon ,&nbsp;Kriang Tungsanga ,&nbsp;Ryota Nakamura ,&nbsp;Hwee-Lin Wee ,&nbsp;Siobhan Botwright ,&nbsp;Wannisa Theantawee ,&nbsp;Jutatip Laoharuangchaiyot ,&nbsp;Thanakrit Mongkolchaipak ,&nbsp;Thanisa Thathong ,&nbsp;Pritaporn Kingkaew ,&nbsp;Yot Teerawattananon","doi":"10.1016/j.hlpt.2024.100927","DOIUrl":"10.1016/j.hlpt.2024.100927","url":null,"abstract":"<div><h3>Background</h3><div>There has been lots of debate regarding an appropriate value of cost-effectiveness threshold (CET). To our knowledge, Thailand is the only country which has explicit CET and has increased the CET. Therefore, Thailand is in a unique position to help answer the question of what happened when CET was increased. The study objectives were to explore the impact of increasing CET on the submitted medicine price by industry and the decision to be included in the National List of Essential Medicine in Thailand.</div></div><div><h3>Methods</h3><div>Retrospective secondary data analyses were conducted using data from economic evaluation reports being reviewed by the National Drug Subcommittee. In total, 55 reports were included in the analysis, which represented 295 observations as each report could have more than one medicine for different indication and/or target population. The intervention of interest was the change in CET policy from 100,000 THB/QALY in 2008 to 120,000 THB/QALY in 2010 to 160,000 THB/QALY in 2013.</div></div><div><h3>Results</h3><div>There is no evidence suggesting the increase in CET affected the submitted medicine prices (price change=19%, p-value=0.457) or increased the likelihood of a positive reimbursement decision (OR=1.596, p-value=0.532). There were other factors which may influence medicine prices and reimbursement decision.</div></div><div><h3>Conclusions</h3><div>The change in the CET did not significantly affect health resource allocation. The findings do not support whether the current CET value in Thailand should be increased. Future research should continue to monitor the submission and re-analyse the current work as more data become available using both quantitative and qualitative approaches.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 6","pages":"Article 100927"},"PeriodicalIF":3.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflecting on relaxing zero-COVID and moving forward with positivity: A population-based quantitative and qualitative study","authors":"Ruihua Li ,&nbsp;Chuanning Huang ,&nbsp;Beier Guan ,&nbsp;Jiang Du ,&nbsp;Min Zhao ,&nbsp;Shuyan Liu","doi":"10.1016/j.hlpt.2024.100929","DOIUrl":"10.1016/j.hlpt.2024.100929","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;The event that China lifted its zero-COVID policy in December 2022 promoted this study to investigate people's responses in terms of health, mood, life satisfaction, and policy satisfaction following the policy relaxation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a cross-sectional online survey one month after relaxing zero-COVID policy among Chinese general population using qualitative and quantitative approaches. Participants rated their health, mood, life satisfaction, and policy satisfaction on a horizontal visual analogue scale ranging from 1 to 100. In addition, we included open-ended questions to gain deeper insights into their responses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Out of 4456 participants, approximately 70 % reported satisfaction following the policy change. Those with recent COVID-19 infection (N = 3308) rated lower scores in health, mood, life satisfaction, and policy satisfaction than those without recent infection. A multiple linear regression model revealed that the absence of recent COVID-19 infection, higher life satisfaction, and greater policy satisfaction were associated with better mood. Interestingly, participants who experienced increases in life and policy satisfaction also had better moods. Qualitative analysis revealed an improved mood of participants, reflecting a desire to return to normal life despite a preference for a gradual and well-prepared transition policy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study highlighted positive changes following the relaxation of zero-COVID policy. Strategies aiming at post-COVID-19 recovery should prioritize individuals who have contracted the virus while promoting life and policy satisfaction amongst the general population.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Public Interest Summary&lt;/h3&gt;&lt;div&gt;China's decision to lift its dynamic zero-COVID policy on December 7, 2022, marked a significant shift in COVID-19 control measures, ushering in immediate stressors and challenges. Our study, employing both quantitative and qualitative methods, sought to understand how the general population in China responded to this transition. We found that participants reported above-average levels of self-assessment health, mood, life satisfaction, and policy satisfaction following the relaxation of the zero-COVID policy. Notably, those with recent COVID-19 infection reported lower satisfaction levels than those without recent infection. Moreover, the absence of recent COVID-19 infection, higher life satisfaction, and greater policy satisfaction were associated with better mood outcomes. In addition, we observed a positive synergistic effect between life satisfaction and policy satisfaction on mood. Despite a preference for a gradual and well-prepared transition policy, participants showed improved mood, reflecting an inclination towards a return to normalcy. Our study captured this pivotal moment of policy change, revealing positive changes to move forward amid complex","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 6","pages":"Article 100929"},"PeriodicalIF":3.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}