Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands.
IQVIA, Amsterdam, Netherlands.
Pharmacoeconomics. 2023 Sep;41(9):1031-1050. doi: 10.1007/s40273-023-01304-4. Epub 2023 Aug 17.
Compensation mechanisms and multiplier effects may affect productivity losses due to illness, disability, or premature death of individuals. Hence, they are important in estimating productivity losses and productivity costs in the context of economic evaluations of health interventions. This paper presents a systematic literature review of papers focusing on compensation mechanisms and multiplier effects, as well as whether and how they are included in health economic evaluations.
The systematic literature search was performed covering EconLit and PubMed. A data-extraction form was developed focusing on compensation mechanisms and multiplier effects.
A total of 26 studies were included. Of these, 15 were empirical studies, three studies were methodological studies, two studies combined methodological research with empirical research, four were critical reviews, one study was a critical review combined with methodological research, and one study was a cost-benefit analysis. No uniform definition of compensation mechanisms and multiplier effects was identified. The terminology used to describe compensation mechanisms and multiplier effects varied as well. While the included studies suggest that both multipliers as well as compensation mechanisms substantially impact productivity cost estimates, the available evidence is scarce. Moreover, the generalizability as well as validity of assumptions underlying the calculations are unclear. Available measurement methods for compensation mechanisms and multiplier effects differ in approaches and are hardly validated.
While our review suggests that compensation mechanisms and multiplier effects may have a significant impact on productivity losses and costs, much remains unclear about their features, valid measurement, and correct valuation. This hampers their current inclusion in economic evaluation, and therefore, more research into both phenomena remains warranted.
补偿机制和乘数效应可能会影响个体因病、残疾或过早死亡而导致的生产力损失。因此，在对卫生干预措施进行经济评估时，它们对于估算生产力损失和生产力成本非常重要。本文对重点关注补偿机制和乘数效应的文献进行了系统综述，以及这些机制和效应是否以及如何被纳入卫生经济评估。
系统文献检索涵盖了 EconLit 和 PubMed。制定了一个数据提取表格，重点关注补偿机制和乘数效应。
共纳入 26 项研究。其中，15 项为实证研究，3 项为方法学研究，2 项将方法学研究与实证研究相结合，4 项为批判性评论，1 项为批判性评论与方法学研究相结合，1 项为成本效益分析。没有确定补偿机制和乘数效应的统一定义。用于描述补偿机制和乘数效应的术语也存在差异。虽然纳入的研究表明，乘数和补偿机制都对生产力成本估算有重大影响，但现有证据仍然很少。此外，计算所依据的假设的通用性和有效性也不清楚。补偿机制和乘数效应的现有测量方法在方法上存在差异，几乎没有经过验证。
尽管我们的综述表明补偿机制和乘数效应可能对生产力损失和成本产生重大影响，但它们的特征、有效测量和正确估值仍有很多不清楚的地方。这阻碍了它们在经济评估中的当前纳入，因此，需要对这两种现象进行更多的研究。
