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Value in Health Regional Issues

Syed Shahzad Hasan, Chia Siang Kow, Dalia Dawoud, Omneya Mohamed, Darrin Baines, Zaheer-Ud-Din Babar
Medicine price directly affects affordability and access to medicines particularly in countries where a major portion of pharmaceutical spending is through out-of-pocket payment, such as in the Asia Pacific region. We have undertaken a detailed appraisal of the pharmaceutical policy reforms to regulate drug prices in 3 developed (Australia, New Zealand, and South Korea) and 3 emerging (China, India, and Malaysia) economies of the Asia Pacific region. Despite continuous efforts by the authorities in adopting a wide range of reformatory pharmaceutical pricing policies to ensure affordability of medicines, these policies may not be optimal where drug prices were not lowered as expected (eg, in Korea)...
November 6, 2018: Value in Health Regional Issues
Rei Goto, Takeshi Mori
BACKGROUND: Setting priorities for limited public resources has become a topic of heated discussion the world over. Assigning different weights for the health gains of different population groups allows for equity considerations in cost-effectiveness analysis. However, only a few empirical works have elicited the preferences of the general public. OBJECTIVE: To compare the equity preferemce assigned by Japanese and Koreans. METHODS: We conducted a Web-based survey in March 2013, including a discrete choice experiment, to elicit the equity preferences of the general public for the life expectancy gains of different population groups...
November 6, 2018: Value in Health Regional Issues
Amit Dang, Jitendar Kumar Sharma
Most of the industrial sectors of India have undergone major changes in the post-liberalization period. During this period, India has become self-reliant in drugs; however, still, 75% of the medical devices are imported in India. According to WHO, almost all devices present in the developing countries have been designed for use in the industrialized countries. With the increase in incidence of non-communicable diseases and decrease in communicable diseases; increase in survival rates and decrease in mortality rates, and increase in ageing population, the healthcare demands have changed in the last decade...
November 6, 2018: Value in Health Regional Issues
Xinyan Li, Weichen Li, Lingping Hou
BACKGROUND: The first-line bevacizumab plus chemotherapy resulted in a clinical efficacy for Chinese patients with advanced nonsquamous non-small-cell lung cancer (NSCLC). Some economic analyses have carried out various methods to evaluate the cost-effectiveness of bevacizumab as the first-line treatment for NSCLC in other countries. Our objective was to assess the cost-effectiveness of bevacizumab plus chemotherapy compared with chemotherapy alone for the first-line treatment of advanced nonsquamous NSCLC...
November 6, 2018: Value in Health Regional Issues
Malwina Holownia-Voloskova, Pavel A Vorobiev, Maxim Grinin, Maria V Davydovskaya, Tatiana N Ermolaeva, Konstantin A Kokushkin
OBJECTIVES: To describe characteristics of the drug policy in Russia in terms of health technology assessment (HTA), registries of patients, pricing of drugs, cost-containment methods, and reimbursement of drugs. METHODS: The legal and regulatory frameworks and the literature were reviewed to analyze several aspects of Russian healthcare: the scheme of cooperation between its structures, its levels, drug provision, issues related to HTA, the reimbursement system, pricing of medicines, and cost-containment methods...
October 13, 2018: Value in Health Regional Issues
Maria Del Carmen Rodríguez-Zepeda, Lourdes González, Amalia Bravo, Teresa Pompa, Salvador Silva, Rogelio Paredes, Jaime García, Mafalda Ramos, Lars Wilkinson, Mark Lamotte
OBJECTIVE: To compare the costs and clinical consequences of treating mild-to-moderate joint bleeds with recombinant activated factor VII (rFVIIa) versus plasma-derived activated prothrombin complex concentrate (pd-aPCC) in pediatric patients with hemophilia A with inhibitors in Mexico. METHODS: A cost-effectiveness model was developed using TreeAge Pro v14.2.2 software (licensed in the USA) and adapted from a previously published model, with adjustments to reflect local clinical practice...
October 11, 2018: Value in Health Regional Issues
Alexandra Beletsi, Vassiliki Koutrafouri, Eleftheria Karampli, Elpida Pavi
OBJECTIVES: To examine and compare the use of health technology assessment (HTA) for the reimbursement of new medicines in selected European Union member states with decades of experience in the use of HTA and in countries that have used it regularly since 2000. METHODS: The selected countries were categorized into "earlier" adopters (group A: England, Germany, France, and Sweden) and more "recent" adopters (group B: Poland, Bulgaria, Hungary, and Romania)...
October 11, 2018: Value in Health Regional Issues
Sandro René P S Miguel, Ana Flávia B S Lima, Luciane N Cruz, Mírian Cohen, Jacques J Zimmermann, Patrícia K Ziegelmann, Marcelo P A Fleck
OBJECTIVES: To evaluate the effectiveness of an algorithm for the treatment of mixed episodes in bipolar disorder (BD) using the medications available under the Unified Health System (Sistema Único de Saúde) in Brazil. METHODS: The study included 107 individuals with BD in a current mixed episode, assessed biweekly for the outcomes of response and remission. The subjects were randomly assigned to start treatment with lithium, valproic acid, or carbamazepine, following a clinical protocol at a public outpatient clinic...
October 10, 2018: Value in Health Regional Issues
Eva Ornstova, Monika Sebestianova, Tomas Mlcoch, Klara Lamblova, Tomas Dolezal
BACKGROUND: Highly innovative drugs (HIDs) can be granted 2 to 3 years of temporary reimbursement (TR) to provide timely patient access and to collect real-world evidence through registries in the Czech Republic. A TR applicant does not need to comply with cost-effectiveness (CE) requirements and the willingness-to-pay threshold. It is only when mandatory transition to permanent reimbursement (PR) status occurs does the drug need to comply with CE and willingness-to-pay requirements. OBJECTIVES: To describe and evaluate the HID program in the Czech Republic by analyzing the pharmacoeconomic results when a drug starts with TR status and transitions to PR status...
October 10, 2018: Value in Health Regional Issues
Gabriel Tremblay, Vasiliki Chounta, James Piercy, Tim Holbrook, Shan Ashton Garib, Evgeny K Bukin, Yogesh Suresh Punekar
OBJECTIVES: To evaluate the cost effectiveness of dolutegravir + abacavir/lamivudine (DTG + ABC/3TC) compared with raltegravir + abacavir/lamivudine (RAL + ABC/3TC) and ritonavir-boosted darunavir + abacavir/lamivudine (DRV/r + ABC/3TC) in HIV-1-infected treatment-naive patients in Russia. METHODS: A dynamic Markov model was developed with five response states and six CD4+ -based health states. Efficacy estimated as probability of viral suppression (HIV RNA <50 copies/ml) at 48 weeks was obtained from a published network meta-analysis...
October 5, 2018: Value in Health Regional Issues
Nericke Olivier, Martie Lubbe, Rianda Joubert, Adele Naudé, Johanita Burger
OBJECTIVES: To describe antirheumatic medicine prescribing patterns and to estimate the total annual direct medicine cost of rheumatoid arthritis (RA) in the private health sector of South Africa. METHODS: A retrospective, cross-sectional drug utilization study was performed on medicine claims data from January 1, 2014, to December 31, 2014, for a total of 4,352 patients with RA. Patients were divided into those with RA only and those with RA and other chronic disease list conditions...
September 15, 2018: Value in Health Regional Issues
Gabriel Rodrigues Martins de Freitas, Jeruza Lavanholi Neyeloff, Giacomo Balbinotto Neto, Isabela Heineck
OBJECTIVES: To estimate the proportion of patients with drug-related morbidities (DRMs), DRM preventability, and the cost of illness of the DRMs in Brazil. METHODS: We used the decision-analytic model initially developed by Johnson and Bootman (Drug-related morbidity and mortality. A cost-of-illness model. J Manag Care Pharm 1996;2:39-47), which was adapted to the reality of the present study. A hypothetical cohort of patients in ambulatory care setting was simulated considering the perspective of the Brazilian public health system...
September 5, 2018: Value in Health Regional Issues
John N Yfantopoulos, Athanasios Chantzaras
OBJECTIVES: To provide a detailed overview of the recent reforms in pharmaceutical pricing and reimbursement processes as well as in other important areas of the pharmaceutical policy in Greece. METHODS: Information was collected via a structured questionnaire. The study used publicly available resources, such as publications, relevant legislation, and statistical data, while health experts were also consulted. RESULTS: Recent pharmaceutical reforms included significant price cuts, increased co-payments and some provisions for vulnerable groups, rebates/clawbacks, mandatory electronic prescribing and prescription by international nonproprietary name, generics substitution, prescription limits and detailed auditing, centralized procurement, as well as changes in the pricing and reimbursement processes, with the introduction of positive and negative lists and an internal price referencing system...
September 5, 2018: Value in Health Regional Issues
Elias Asfaw Zegeye, Abduljelli Reshad, Eyersualem Animut Bekele, Belay Aurgessa, Zenebech Gella
Health technology assessment (HTA) has previously been implemented only in a fragmented manner in the Ethiopian health sector decision-making cycle, and the sector has been hampered by limited institutional capacity and skilled human resources to inform evidence-based decision making. The country is in the midst of widescale implementation of a community-based health insurance scheme and is preparing for the launch of a social health insurance scheme. The country continues to face a limited financial resource envelope, undergoing an epidemiological transition, and is facing a much greater burden of noncommunicable diseases, for which the essential health benefit package, defined 12 years ago, may no longer be suitable...
September 5, 2018: Value in Health Regional Issues
Manuel Antonio Espinoza, Ruben Rojas, Hildaura Acosta de Patiño
The interest on Multicriteria decision analysis (MCDA) for healthcare priority setting has grown in popularity in the last few years. Literature shows several exercises where MCDA can be used to inform different types of priorities; however, there is little evidence on the feasibility of implementing this method in current institutionalized decision-making processes. We examined the willingness to implement MCDA as a tool to facilitate decision-making in Central America and the Caribbean (CAC). We convene 41 representatives of the healthcare public sector from 10 countries to explore whether they consider MCDA a robust tool to be incorporated in local priority setting processes and which ongoing decision-making process could be benefited from this methodology...
September 2, 2018: Value in Health Regional Issues
Rafael J Vargas Alves, Ana P Beck da Silva Etges, Giácomo Balbinotto Neto, Carisi Anne Polanczyk
BACKGROUND: A review of the literature on economic analyses in cancer (prevention, diagnosis, and treatment) using activity-based costing (ABC) or time-driven activity-based costing (TDABC) for measuring costs and to examine how these approaches have been applied to assess and manage cancer costs. METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a search for studies that used ABC or TDABC to calculate the cost of cancer in prevention, diagnosis, and treatment...
August 24, 2018: Value in Health Regional Issues
Ahmad Al Kadour, Wafa Al Marridi, Daoud Al-Badriyeh
OBJECTIVES: To review literature characteristics, describe methodological trends, and assess the reporting quality of the economic evaluations of oral anticancer drugs (OACDs). METHODS: The review included comparative economic evaluations of OACDs. The search was conducted via PubMed, Embase, EconLit, and Economic Evaluation Database, and studies till December 2017 were included. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, literature inclusion and data extraction were performed in duplicate by separate investigators...
August 22, 2018: Value in Health Regional Issues
Fiona Pearce, Liang Lin, Elaine Teo, Kwong Ng, Daphne Khoo
INTRODUCTION: Singapore has a robust health care system that is well known for delivering good health outcomes. In the public health care sector, subsidies and financial assistance are provided for drugs listed on the Standard Drug List and Medication Assistance Fund. Additional financing mechanisms are also available to provide further support for patients in need. With new technologies entering the market at high costs, health technology assessment (HTA) is playing an increasingly important role to inform their relative value and determine how best to allocate finite health care resources to ensure long-term sustainability of the health care system...
June 25, 2018: Value in Health Regional Issues
María Calderón, Nicole Minckas, Solange Nuñez, Agustín Ciapponi
BACKGROUND: Inflammatory bowel disease (IBD) is the name given to two inflammatory diseases of the colon and/or small intestine: Crohn disease (CD) and ulcerative colitis (UC). There is no information summarizing the complete body of evidence about IBD in developing regions, including Latin America. OBJECTIVES: To estimate the burden of IBD in Latin America. METHODS: We conducted a systematic review searching published and unpublished studies on major international and regional databases from January 2000 to September 2015...
June 21, 2018: Value in Health Regional Issues
Christiane Maskineh, Soumana C Nasser
OBJECTIVES: The first objective is to describe current managed entry agreement (MEA) activity in the Middle East and North African (MENA) region and the pharmaceutical decision makers' perception and use of these agreements; The second objective is to describe the challenges as well as to reflect on the uncertainty related to MEAs implementation and the future outlook for MEAs activities in the region. STUDY DESIGN: A prospective cross-sectional survey. METHODS: A questionnaire was sent to several pharmaceutical manufacturers and public officials involved in pricing and reimbursement of pharmaceuticals in the region...
June 21, 2018: Value in Health Regional Issues
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