ABSTRACT
OBJECT IVE To develop a rapid health technology assessment （rHTA）methodology of drugs based on evidence integration and value judgment ，which is suitable for China ’s national conditions. METHODS The literature review was adopted to study health technology assessment （HTA）and multi-criteria decision analysis （MCDA），and then rHTA method based on China ’s condition was formulated preliminarily with anti-tumor drugs ；the method of rHTA was demonstrated by expert consultation ； finally，the feasibility of rHTA was preliminarily verified taking the drugs for the treatment of non-small cell lung cancer as an example. RESULTS Established rHTA method combined the theory and principles of HTA and MCDA ：HTA method was used to guide the collection and synthesis of literature and real-world evidence ，while MCDA made the value measurements of achievable evidences by various stakeholders from different views ；it established the working process ，evaluation dimensions ，evaluation indicators and scoring system of rHTA. The feasibility of this method was verified by the drug example of treating non-small cell lung cancer. CONCLUSIONS A set of drug-driven rHTA methodology guidance based on HTA and MCDA is established. It can quickly collect and integrate evidence ，and provide evidence support for decision makers in a short time.
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OBJECTIVE：To evalua te the economics of glecaprevir/pibrentasvir （G/P）versus elbasvir/grazoprevir （EBR/GZR） in chronic hepatitis C genotype 1b（GT1b）treatment-naive patients without cirrhosis ，and to provide evidence support for medical and health decision-making. METHODS ：Under assuming the bid price of G/P and EBR/GZR therapy schemes before medical insurance negotiation was adopted （scenario 1）and assuming that the price of EBR/GZR was reduced by 85％ and the price of G/P was reduced by 80％（scenario 2），Markov model was developed to simulate the lifetime cost and health outcomes progress of 10 000 untreated chronic hepatitis C GT 1b treatment-naive patients without cirrhosis and calculate incremental cost-effectiveness ratio（ICER）. Single factor sensitivity analysis and probability sensitivity analysis were conducted to verify the results. The highest price（price reduction ratio ）of G/P scheme was analyzed with cost-effectiveness advantage ，when other parametes kept stable under scenario 2. RESULTS ：Under 2 kinds of scenarios ，compared with EBR/GZR scheme ，G/P scheme had higher cost （scenario 1：68 800 yuan vs. 62 338 yuan；scenario 2：13 760 yuan vs. 11 490 yuan）and healty utility （scenario 1：14.97 QALY vs. 14.90 QALY；scenario 2：14.97 QALY vs. 14.90 QALY），and ICER value of G/P was lower than willingness-to-pay threshold （scenario 1：92 314 yuan/QALY；scenario 2：32 428 yuan/QALY）. The change of most parameters in single factor sensitivity analysis didn ’t influence the results of base-case analysis ，and the findings from the base-case analysis were confirmed by probability sensitivity analyses. The price of G/P scheme needed to be reduced by at least 62％ to realize cost-effective advantage. CONCLUSIONS ： Under the set price scenario ，G/P scheme has cost-effectiveness advantages than EBR/GZR scheme in chronic hepatitis C GT 1b treatment-naive patients without cirrhosis.
ABSTRACT
OBJECTIVE： To evaluate the accessibility of essential medicine for common chronic disease in primary health care institutions in Hubei province， and to provide evidence for improving essential medicine policy and strengthening the management level of chronic disease. METHODS： The purchase data of essential medicine for 6 kinds of common chronic disease （diabetes， hypertension， gastric ulcer， asthma， rheumatoid arthritis and epilepsy） were collected from centralized drug procurement platform of Hubei province from 2015 to 2017； essential medicin equipping rate was used to evaluate the availability， and minimum daily wage was used to evaluate the affordability. So that accessibility could be analyzed and suggestions for improving accessibility and affordability were put forward. RESULTS： From 2015 to 2017， the equipping rate of essential drugs varied from 40.00％ to 71.43％，and the availability of those medicine for common chronic disease was at a low level. The affordability improved slightly （the ratio of medication cost to minimum daily wage was decreased from 1.91 to 1.79 from 2015 to 2017） but remained low， and the ratio of medication cost to minimum daily wage for more than 70％ of 21 drugs was less than 1. CONCLUSIONS： Since the accessibility of essential medicine for common chronic disease was at a low level in Hubei province， it is suggested to optimize kinds of essential medicine for chronic disease， to promote the construction of hierarchical medical system， to reduce the price of essential medicine for chronic disease， and to improve the compensation mechanism of essential medicine for chronic disease to further strengthen the management of chronic disease in primary health care institutions.