Show Abstract: Background Equity is rarely included in health economic evaluations, partly because the techniques for addressing equity have been inadequate. Since 2013 health economists have developed two competing health economic technologies: distributional costeffectiveness analysis (DCEA) and extended cost-effectiveness analysis (ECEA). Both technologies represent a significant advance, and each provides a framework to address equity considerations in cost-effectiveness analysis. Methods A scoping literature review was used to identify and synthesise the relevant literature on incorporating equity concerns into economic evaluations. A second focused review identified literature which discussed or applied DCEA and ECEA. Key themes in the literature were identified using NVivo qualitative data analysis software. Results The review revealed three key areas of difference between DCEA and ECEA: First, the analysis of trade-offs between improving health and reducing inequity; second, the analysis of financial impacts of health policies; and third, the incorporation of opportunity costs. ECEA can analyse financial risk protection while DCEA can analyse opportunity costs and trade-offs between improving equity and reducing health. ECEA is designed for low- and middle-income countries, whereas DCEA is better suited to developed health systems such as the National Health Service in the United Kingdom. To date, there have been 27 studies using ECEA and five studies using DCEA. Future developments for DCEA and ECEA include incorporating alternative methods to simplify the data requirements for the techniques, providing methods to assist decision makers to clarify their equity concerns, and improving the presentation of outcomes to make them accessible to non-specialists. Conclusions DCEA and ECEA are both economic frameworks which address equity considerations in cost-effectiveness analysis. This study examines and compares these two techniques in order to assist policymakers and decision makers to determine which of the two methods is best able to address their specific needs for their particular circumstances. Reference: Lewis, I.S. 2021. Addressing Health Equity in Cost-Effectiveness Analysis: A Review of Distributional and Extended Cost-Effectiveness Analysis. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/35910 Lewis, I. S. (2021). Addressing Health Equity in Cost-Effectiveness Analysis: A Review of Distributional and Extended Cost-Effectiveness Analysis. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/35910 Lewis, Ian Storm. "Addressing Health Equity in Cost-Effectiveness Analysis: A Review of Distributional and Extended Cost-Effectiveness Analysis." ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2021. http://hdl.handle.net/11427/35910 Lewis IS. Addressing Health Equity in Cost-Effectiveness Analysis: A Review of Distributional and Extended Cost-Effectiveness Analysis. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/35910
 Under a Creative Commons license Open access Highlights• Equity-informative cost-effectiveness analysis (CEA) methods have been proposed to formally examine the equity effects of different interventions. Equity-informative CEAs quantify the distributional impacts of health interventions based on different equity criteria. •Since equity-informative CEAs were developed and proposed, their applications have not been systematically assessed to understand what conditions and interventions they have been used for, as well as their reporting quality. This systematic review aims to fill that gap by cataloguing and describing peer-reviewed applications of equity-informative CEAs to date. •Equity-informative CEAs are not only increasing but have been applied to a range of equity criteria, disease areas, intervention types, and populations, which suggests that broad application of these methods is feasible but will require further refinement. AbstractObjectiveThis systematic review aims to catalogue and describe published applications of equity-informative cost-effectiveness analysis (CEAs). MethodsFollowing PRISMA guidelines, we searched Medline for English-language, peer-reviewed CEAs published on or before August 2019. We included CEAs that evaluated 2 or more alternatives; explicitly mentioned equity as a consideration or decision-making principle; and applied an equity-informative CEA method to analyze or examine at least 1 equity criterion in an applied CEA. We extracted data on selected characteristics and analyzed reporting quality using the CHEERS checklist. ResultsFifty-four articles identified through a search and bibliography reviews met the inclusion criteria. All articles were published on or after 2010, with 80% published after 2015. Most studies evaluated primary prevention interventions in disease areas such as cancer, infectious diseases, and cardiovascular disease. Equity impact analysis alone was the most common equity-informative CEA (56%), followed by equity impact analysis with financial protection effects (30%). At least 11 different equity criteria have been used in equity-informative CEAs; socioeconomic status and race/ethnicity were used most frequently. Seventy-eight percent of studies reported finding “greater value” in an intervention after examining its distributional effects. ConclusionThe number of equity-informative CEAs is increasing, and the wide range of equity criteria, diseases, interventions, settings, and populations represented suggests that broad application of these methods is feasible but will require further refinement. Inclusion of equity into CEAs may shift the value of evaluated interventions and can provide crucial additional information for decision makers. Keywordsdistributional cost-effectiveness analysis equity-informative cost-effectiveness analysis equity weighting health equity Cited by (0)© 2020 ISPOR-The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. |
Incorporating equity concerns in cost-effectiveness analyses: a systematic literature review
zusammenhängende Posts
Urheberrechte © © 2024 ketiadaan Inc.
