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

Author

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

Subjects
China, multicriteria decision analysis, MCDA, insurance policy, decision-making, stakeholder engagement, medical savings account, bic Book Industry Communication::M Medicine::MB Medicine: general issues::MBN Public health & preventive medicine::MBNH Personal & public health::MBNH9 Health psychology
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
2020
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20. 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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25. 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, primary, Gultyaev, Dmitry, additional, Lister, Johanna, additional, Han, Rong, additional, Hu, Nan, additional, Malacan, Jean, additional, Solms, Alexander, additional, Vashi, Parth, additional, O’Hara, Jamie, additional, and Hu, Shanlian, additional

Published
2022
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37. 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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41. Patient–physician trust in China: a workshop summary

Author

Chan, Cheris S C, primary, Cheng, Yu, additional, Cong, Yali, additional, Du, Zhizheng, additional, Hu, Shanlian, additional, Kerrigan, Amanda, additional, Kleinman, Arthur, additional, Li, Mengfeng, additional, Liebman, Benjamin, additional, Ma, Yonghui, additional, Nie, Jing-Bao, additional, Tsai, Daniel F C, additional, Tsai, Duujian, additional, Tucker, Joseph D, additional, Wang, Lijie, additional, Wong, Bonnie, additional, Wong, William C W, additional, Xiao, Zeping, additional, Xu, Juncai, additional, Yan, Yunxiang, additional, Yang, Yang, additional, Zhang, Daqing, additional, Zhao, Mingjie, additional, Zhu, Jianfeng, additional, and Zhu, Wei, additional

Published
2016
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43. Need for hyperlipidemia management policy reform in China: learning from the global experience.

Author

Wei Yu, Ruizhi Shi, Jim Li, Yong Lan, Qian Li, Shanlian Hu, Yu, Wei, Shi, Ruizhi, Li, Jim, Lan, Yong, Li, Qian, and Hu, Shanlian

Subjects
HYPERLIPIDEMIA treatment, HEALTH policy, HEALTH care reform
Abstract

Objective: To evaluate the hyperlipidemia prevention programs and policies in different countries and highlight the need of reforming the hyperlipidemia prevention policies in China to lower the growing cardiovascular disease (CVD) risk.Research Design and Methods: PubMed, Google Scholar and Cochrane were searched for global hyperlipidemia prevention policies. Government-funded policies pertaining to lipid management were considered for this review. Only those studies that evaluated the success of prevention policies on the basis of: (i) achievement of hyperlipidemia targets; (ii) improvement in Cardiovascular (CV) risk reduction; and (iii) outcomes with reduction in hyperlipidemia after implementation of the policy, were included.Results: Several global policies and programs aimed to improve CV health by highlighting lipid profile management. Implementation of the global and national policies led to improvement in cholesterol related outcomes such as availability of diagnostic measures, awareness of the risk factors, decrease in cholesterol levels, achieving healthy lifestyle to prevent CVD and improvement in availability of hypolipidemic medications, etc. Statins have been covered under reimbursement policies in many countries to improve usage and thereby preventing incidence of stroke and CVD. We observed a need for introducing new programs in China as the ongoing hyperlipidemia management policies are inadequate. The World Bank Report 2016 recommended that prevention policies in China be modeled on the US Million Hearts program.Conclusions: New hyperlipidemia prevention policies must set a time-bound target, and need to be patient and clinician centric in terms of applications, and revised periodically for long-term benefits. [ABSTRACT FROM AUTHOR]

Published
2018
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47. 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

49. 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

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