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6. Disutilities Associated with Intravenous Iron Infusions: Results from a Time Trade-off Survey and Diminishing Marginal Utility Model for Treatment Attributes in China

Author

Hu,Shanlian, Wu,Depei, Wu,Jing, Zhang,Yabing, Bøgelund,Mette, Pöhlmann,Johannes, Pollock,Richard F, Hu,Shanlian, Wu,Depei, Wu,Jing, Zhang,Yabing, Bøgelund,Mette, Pöhlmann,Johannes, and Pollock,Richard F

Abstract

Shanlian Hu,1 Depei Wu,2 Jing Wu,3 Yabing Zhang,4 Mette Bøgelund,5 Johannes Pöhlmann,6 Richard F Pollock6 1School of Public Health, Fudan University, Shanghai, People’s Republic of China; 2First Affiliated Hospital of Soochow University, Soochow University, Suzhou, People’s Republic of China; 3School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, People’s Republic of China; 4Shanghai Institute of Technology, Shanghai, People’s Republic of China; 5Incentive Partners ApS, Holte, Denmark; 6Covalence Research Ltd, Harpenden, United KingdomCorrespondence: Richard F Pollock, Covalence Research Ltd, Rivers Lodge, West Common, Harpenden, AL5 2JD, United Kingdom, Tel +44 20 8638 6525, Email pollock@covalence-research.comPurpose: Treatment process attributes can affect health state utilities associated with therapy. For intravenous iron, used to treat iron deficiency and iron deficiency anemia, research into process attributes is still lacking. This study estimated utilities associated with process attributes for intravenous iron infusions.Methods: An online survey including seven health state vignettes and time trade-off tasks was administered to participants, who were not patients living with iron deficiency or iron deficiency anemia, from a Chinese online panel. Vignettes used an identical description of iron deficiency and iron deficiency anemia but differed in the annual number of infusions, infusion duration, and infusion-associated risk of hypophosphatemic osteomalacia. Disutilities and their rate of change as the number of infusions increased were examined using a power model.Results: The survey was completed by 1091 participants. The highest utilities were observed for one annual infusion of 15– 30 minutes or 30– 60 minutes, without risk of hypophosphatemic osteomalacia (0.754 and 0.746, respectively). In comparison, more infusions and infusions with a risk of hypophosphatemic osteomalacia were associated with lower utilities. Ut

Published
2023

14. Additional file 1 of Pharmacokinetic parameter driven outcomes model predicts a reduction in bleeding events associated with BAY 81–8973 versus antihemophilic factor (recombinant) plasma/albumin-free method in a Chinese healthcare setting

Author

Chen, Rong, Gultyaev, Dmitry, Lister, Johanna, Han, Rong, Hu, Nan, Malacan, Jean, Solms, Alexander, Vashi, Parth, O’Hara, Jamie, and Hu, Shanlian

Abstract

Additional file 1: Table S1. BAY 81-8973 and rAHF-PFM PK parameters(7). Figure S1. Cost-effectiveness scatterplot.

Published
2022
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23. The cost-effectiveness of a NSCLC patient assistance program for pemetrexed maintenance therapy in People's Republic of China

Author

Shi,Qiang, Hu,Shanlian, Furnback,Wesley, Guzauskas,Gregory, Shen,Jiejing, Wang,Bruce, Shi,Qiang, Hu,Shanlian, Furnback,Wesley, Guzauskas,Gregory, Shen,Jiejing, and Wang,Bruce

Abstract

Qiang Shi,1 Shanlian Hu,2 Wesley E Furnback,3 Gregory F Guzauskas,3 Jiejing Shen,1 Bruce CM Wang3 1Lilly Suzhou Pharmaceutical Company, Ltd., Shanghai, People’s Republic of China; 2Shanghai Health Development Research Center, Shanghai, People’s Republic of China; 3Elysia Group, Ltd., Taipei, Taiwan, Republic of China Background: Eli Lilly and the China Primary Health Care Foundation are currently implementing a patient assistance program (PAP) in China, which allows first-line nonsquamous non-small-cell lung cancer (NSCLC) patients who complete four cycles of pemetrexed induction therapy to receive free, continuous pemetrexed maintenance therapy.Objective: To estimate the cost-effectiveness of pemetrexed maintenance therapy vs basic standard care (BSC) and the economic impacts of providing a PAP for pemetrexed maintenance therapy to NSCLC patients who have completed pemetrexed induction therapy in a Chinese health care setting.Methods: We developed a novel decision-analytic model to evaluate the long-term costs and clinical efficacy of pemetrexed plus BSC vs BSC alone. We utilized a three-state (progression-free survival, progressed disease, and dead) partition survival model for both the clinical and economic aspects of the analysis. Cost and health utility estimates were derived from the literature. We performed a scenario analysis to estimate the real-world impact of introducing the PAP in China by comparing the use of the PAP vs non-PAP. Model uncertainty was evaluated using one-way and multivariate probabilistic sensitivity analysis.Results: Compared to BSC, pemetrexed plus BSC resulted in a gain of 0.22 years of life (95% credible range [CR]: 0.04–0.46) and 0.13 quality-adjusted life years (95% CR: 0.04–0.26) per patient, at an increased cost of $28,105 (95% CR: −$22,720 to $48,646) without a PAP and $3,068 (95% CR: −$1,263 to $9,163) with a PAP. The incremental cost-effectiveness ratio for pemetrexed

Published
2017

26. Cost–effectiveness analysis of intravitreal aflibercept in the treatment of diabetic macular edema in China

Author

Ming, Jian, Zhang, Yabing, Xu, Xun, Zhao, Mingwei, Wang, Yusheng, Chen, Youxin, Zhang, Feng, Wang, Jiawei, Liu, Jun, Zhao, Xinran, Han, Rong, and Hu, Shanlian

Abstract

Aim:To evaluate the cost–effectiveness of intravitreal aflibercept compared with macular laser photocoagulation and ranibizumab for diabetic macular edema (DME) in China. Methods:A Markov model was developed to reflect the vision changes in DME patients. Parameters were estimated from VIVID-EAST trial data, published literature and physician surveys. Results:In a 20-year horizon, intravitreal aflibercept was associated with 7.825 quality-adjusted life years (QALYs) and 217,841 Chinese Yuan Renminbi (CNY), laser photocoagulation was associated with 7.189 QALYs and 135,489 CNY, and ranibizumab was associated with 7.462 QALYs and 222,477 CNY. The incremental cost–effectiveness ratios were 129,397 CNY/QALY and -12,774 CNY/QALY for intravitreal aflibercept versus laser photocoagulation and ranibizumab, respectively. Conclusion:Intravitreal aflibercept was considered as a cost-effective strategy for DME when compared with laser photocoagulation; it was considered as a dominant strategy when compared with ranibizumab.

Published
2024
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28. WBI-China Health Sector Partnership : Fourteen Years and Growing

Author

Chialing Yang, Hu Shanlian, and Abdo S. Yazbeck

Subjects
Health, Nutrition and Population - Health Policy and Management Health Economics and Finance Health, Nutrition and Population - Health Service Management and Delivery Governance - National Governance
Published
2004

30. Factors associated with the decline of the Cooperative Medical System and barefoot doctors in rural China

Author

Zhu, Naisu, Ling, Zhihua, Shen, Jie, Lane, J.M., and Hu, Shanlian

Subjects
Public health -- Evaluation, Community health services -- Evaluation, Medical care -- Evaluation, Rural health services -- Evaluation, China -- Health aspects
Abstract

Over the past fifty years, the health status of the people in China has improved dramatically. The medical system in China, the Cooperative Medical System (CMS), has provided health care to the rural population by means of 'barefoot doctors,' who provide both preventive and curative care. Patients who are seriously ill are referred to communal health centers and, if need be, are then sent to county hospitals, which serve from 200,000 to 600,000 people. However, over the past 10 years, the CMS has been in a decline, both financially and politically. The number of rural Chinese who were covered by the system has declined from 85 percent in 1975, to 40 percent in 1985. There are several possible reasons for the decline including: the lack of money after economic change in China in 1980; the control of the preventable diseases; or political changes. To understand the reasons for the decline, surveys were conducted among the villagers, the barefoot doctors, and the local administrators in three counties, Fengxian, Shanggoa, and Loaan. The three counties ranged in economic status from poor to good. The people and the doctors were found to be satisfied with the health care system. Overall, the CMS was found to be in a good financial state and its use did not decline to the same extent in all areas. In Fengxian, which is a relatively affluent county, the CMS is still prevalent. In areas where the services of the CMS have declined, the health of individuals, as measured by infant mortality, immunization coverage, and the incidence of infectious diseases, has diminished. Villagers now spend more on health care, while less money is available to train the doctors. Therefore, the decline of the CMS is not due to poor medical care, financial problems, lack of accessibility, inadequate facilities, nor to dissatisfactions with the system. It appears that the reason for the decline is because local community leaders thought it was no longer backed by the central government. Local administrators may not want to pay for preventive services unless they are backed by the government. National commitment and community involvement are both necessary for the health care system to be effective. (Consumer Summary produced by Reliance Medical Information, Inc.), Introduction Since 1949, when the People's Republic of China was founded, indices of health in that country have improved dramatically; for example, from 1950 to 1982, the infant mortality rate [...]

Published
1989

32. Universal coverage and health financing from China's perspective

Author

Hu, Shanlian

Subjects
Health insurance -- Evaluation, Health care reform -- Evaluation
Abstract

Universal coverage of health services is required to ensure social equity and justice, particularly for China, which is a developing country with an enormous population. Since the 1980s, the Chinese [...]

Published
2008

33. Value-Based Evaluation of Chinese Provincial Health Insurance Policy Schemes

Author

Holtorf, Anke-Peggy, Hu, Shanlian, Brixner, Diana, Wijaya, Kalman, and He, Jiangjiang

Subjects
Medical
Abstract

Since 2011, an international group of health policy experts has been working on a value-framework to be used for pharmaceutical policy decisions based on multicriteria decision analysis (MCDA). This tool can be easily adapted to a local decision-making context through a facilitated workshop format. Several workshops have been conducted in emerging markets to test the acceptance and feasibility of using MCDA in local decision-making. In China, national policy goals for expanding health-care coverage pressure the provincial governments to implement more comprehensive coverage schemes. This chapter demonstrates the adaptation of a global value-framework to the local policy environment. In September 2018, nine leaders from provincial health insurance bureaus responsible for the urban employee basic medical insurance (UEBMI) participated in a 1-day workshop to build a consensus on the most important objectives for the health-care reform and to translate these into measurable criteria. The participants ranked the criteria by importance and MCDA methodology was used for weighing the importance of each criterion in the final decision. The model driving this process will be presented and discussed by comparing two policy options for health-care reform.

Published
2019

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