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在中国建立价值评估框架的属性识别:一项定性研究。

Identifying Attributes for a Value Assessment Framework in China: A Qualitative Study.

机构信息

Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.

Institute of Clinical Research and Evidence-Based Medicine, Gansu Provincial Hospital, Lanzhou, Gansu, China.

出版信息

Pharmacoeconomics. 2023 Apr;41(4):439-455. doi: 10.1007/s40273-022-01235-6. Epub 2023 Feb 2.

Abstract

BACKGROUND

Value assessment frameworks (VAFs) are promising tools for measuring the value of health technologies and informing coverage policymaking; however, most published VAFs were developed for high-income countries. This study aimed to identify value attributes as part of the development of a VAF in China.

METHODS

We used the qualitative description approach. Specifically, we conducted open-ended semi-structured interviews with Chinese stakeholders, as well as a review and analysis of publicly available government documents related to health technology assessment (HTA) and coverage policies in China. Conventional content analysis and the constant comparison technique were used to generate value attributes. Multiple criteria were used to determine the inclusion of a value attribute, with response levels of included attributes finalized via consensus meetings among the research team.

RESULTS

Thirty-four stakeholders living or working in China completed the semi-structured interview. These stakeholders included policymakers (n = 4), healthcare providers (n = 8), HTA researchers (n = 6), patients and members of the general public (n = 9), and industry representatives (n = 7). In addition, 16 government documents were included for analysis. Twelve value attributes grouped in eight categories are included in the VAF: (1) severity of disease; (2) health benefit, including survival, clinical outcomes, and patient-reported outcomes; (3) safety; (4) economic impact, including budget impact to payer and patients, and cost effectiveness; (5) innovation; (6) organizational impact; (7) health equity; and (8) quality of evidence.

CONCLUSION

These 12 value attributes were identified for the development of a VAF to support health technologies' value assessment and coverage policymaking in China.

摘要

背景

价值评估框架(VAF)是衡量卫生技术价值并为覆盖决策提供信息的有前途的工具;然而,大多数已发表的 VAF 是为高收入国家开发的。本研究旨在确定价值属性,作为在中国开发 VAF 的一部分。

方法

我们使用定性描述方法。具体来说,我们对中国利益相关者进行了开放式非结构化访谈,并对与中国卫生技术评估(HTA)和覆盖政策相关的公开政府文件进行了审查和分析。常规内容分析和恒比技术用于生成价值属性。使用多种标准来确定价值属性的纳入,通过研究团队之间的共识会议确定纳入属性的响应水平。

结果

34 位在中国生活或工作的利益相关者完成了半结构化访谈。这些利益相关者包括政策制定者(n=4)、医疗保健提供者(n=8)、HTA 研究人员(n=6)、患者和普通公众成员(n=9)和行业代表(n=7)。此外,还纳入了 16 份政府文件进行分析。该 VAF 包含 12 个价值属性,分为 8 类:(1)疾病严重程度;(2)健康效益,包括生存、临床结果和患者报告的结果;(3)安全性;(4)经济影响,包括支付者和患者的预算影响以及成本效益;(5)创新性;(6)组织影响;(7)健康公平;和(8)证据质量。

结论

这些 12 个价值属性是为开发 VAF 以支持中国卫生技术的价值评估和覆盖决策而确定的。

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