Study of health state disutility value estimation of malignant tumor drugs-related adverse events ：a systematic review / 中国药房

OBJECTIVE To provide methodology re ference for conducting health state disutility estimation and calculating health output in pharmacoeconomic evaluation. METHODS Literatures about health state disutility estimation of malignant tumor drugs-related adverse events were retrieved from 3 Chinese databases such as CNKI ，Wanfang database and VIP and 3 English database such as PubMed ，Web of Science and the Cochrane Library from inception to July 2021. After 2 researchers independently screened the literature and extracted the data ，qualitative analysis was conducted. The modified decision-making technical support documents of the National Institute for Health and Care Excellence were used for quality evaluation. The practice and existing problems of health state disutility measurement were summarized to put forward some suggestions. RESULTS A total of 77 literatures were included. The first literature was published in 1991，and the number of publications increased in a fluctuating manner. 77 literatures involved 120 kinds of adverse events ，mainly utility studies （49，63.64％），only 3 （3.90％） were investigated in China. A total of 35 literatures（45.45％）had no statement of study design type ，48（62.34％）had no statement of health status development method ，52（67.53％）had no statement of health status verification method ，46（59.74％）set and explained the basic health status ，and 20（25.97％）were ranked for the health status . The utility measurement tools used were mainly the standard game method and the European five-dimensional health scale （23 literatures each ，accounting for 29.87％）. The research objects of 45 literatures（58.44％）were patients ，and 63（81.82％）did not specify the representative test of the population. Utility report types included negative value ，non-negative value and non-negative value of consolidated basic status. A total of 45 literatures（58.44％）had no statement of statistical method of utility. Overall quality score of included studies was 0.683. CONCLUSIONS The current disutility estimation include 4 key links of basic study design ， health status confirmation， utility estimation survey and survey data E-mail：luyuqiong96@foxmail.com statistics. The deficiencies of related studies are the lack of data based on the Chinese population ，the inconsistent type ofresult reporting ，and the incomplete report of measurement- related critical items. It is recommended to standardize the basic implementation path of disutility estimation ，formulate guidelines for health status utility value estimation ，and strengthen multidisciplinary cooperation so as to improve the quality of health status utility value estimation .

Application of adjusted limited dependent variable mixed model in the mapping of pharmacoeconomic health utility scale / 中国药房

OBJ ECTIVE To introduce adjusted limited dependent variable mixed model （ALDVMM）and study its application in mapping research ，so as to provide reference for pharmacoeconomic evaluation that needs to obtain health utility value through mapping. METHODS Using the method of literature research ，ALDVMM was introduced from the aspects of development background，model principle ，model determination and test ，model advantages and the current application of the model in empirical research. RESULTS & CONCLUSIONS ALDVMM is a mixed model developed by foreign scholars for the truncation and multimodality phenomenon of EuroQoL group ’s 5D（EQ-5D）at the health utility value 1. Compared with the traditional model，ALDVMM is feasible and has more advantages ，and can more effectively and flexibly capture the actual distribution of EQ-5D and deal with the boundary value problem ，which is helpful to obtain the health utility value more accurately and efficiently and carry out high-quality pharmacoeconomic evaluation.

Bibliometric Study on Health Utility Value Obtained by Mapping Method in Pharmacoeconomic Evaluation / 中国药房

OBJECTIVE：To know about the research status of health utility value obtained by mapping method in pharmacoeconomic evaluation ，and to provide reference for bibliometric study in pharmacoeconomic evaluation . METHODS ： Using“Mapping method ”“Health utility value ”“Cost-utility”“Utility point system ”as Chinese and English keywords ，retrieved from CNKI ，Wanfang database ，PubMed，Medline，Ebsco，Ovid and Wiley database ，empirical journal documents published from the inception to Dec. 31st，2018 about using mapping method to obtain health utility value were collected. The bibliometrics was used to statistically analyze basic information of included literature ，the construction and test of the model ，the type of the best model and so on. RESULTS ：The 124 included documents were all published in English journal. In the construction and testing of the mapping model ，the most frequently used econometric methods ，performance evaluation indicators and model testing methods were ordinary least squares （OLS），mean absolute error （MAE）and residual normality test ，application frequency of which were 97 times（31.60％），89 times（24.93％）and 62 times（21.09％）. There are 117 articles that define the best mapping model ，of which 101 articles（86.32％）have the best direct mapping effect. Most of the non-utility measurement scales adopted specific scales （92 articles，77.97％），and a few literatures adopted the universal scale （26 articles，22.03％）. The most utility measurement scales were 3-level European 5-dimensional health scale （79 articles，66.95％）. CONCLUSIONS ：The domestic empirical researches that use the mapping method to obtain health utility values need to be developed yet. A series of mapping models successfully developed by foreign scholars not only provide the feasibility of using non-utility measurement scales for cost-utility analysis ，but also provide more ideas for China to choose the corresponding econometric methods ，evaluation indicators and mapping methods in the empirical research of the mapping method in the future.

Introduction and Research Status of 6-Dimensional Health State Classification System / 中国卫生经济

Cost-utility analysis(CUA) was widely used for health care decision-maker.It systematically introduced ShortForm 6D(SF-6D) and described the latest international research and application progress.Compared with EuroQol 5 Dimensions Questionnaire(EQ-5D),SF-6D had higher time validity and more reliable result on estimating patients in some fields.On the other hand,the unity value of SF-6D was estimated based the investigation result of Short Form-36(SF-36) through transferring literature and reports.Based on the method,estimating the health unity of patients' health could make the maximized use of the current data of SF-36,so as to save the costs of pharmacoeconomic.However,further research needs to verify that this transformation model is suitable for Chinese.

Application of multiattribute utility theory in pharmacoeconomic evaluation of anti - inflammatory and hepatoprotective therapy for chronic hepatitis B / 中国基层医药

Objective To evaluate the application of multiattribute utility theory(MAUT) in pharmacoeco-nomic evaluation of anti - inflammatory and hepatoprotective therapy for chronic hepatitis B ( CHB). Methods During year 2014 - 2016,214 patients with mild to moderate CHB were selected. The patients were divided into three groups: A,B and C according to the therapeutic regimen,and they were given compound glycyrrhizin,tiopronin and polyene phosphatidylcholine to prevent inflammation and protect liver. MAUT model was constructed,the evaluation factors were determined and appropriate weight was given to each element parameter,the specific utility values for each factor were calculated,and by calculating the total utility value of final results quantitatively demonstrated the three regimens in the treatment of chronic hepatitis B. Results The total effective rates of A,B,C three groups were 78. 38％ ,69. 44％ ,79. 41％ ,respectively,the difference was statistically significant( χ2 = 5. 559,P < 0. 05). The incidence rates of adverse reaction of A,B,C three groups were 16. 22％ ,8. 33％ ,5. 88％ ,respectively. As to direct cost,group B(1430. 45 yuan) was better than group C(1494. 04 yuan) and group A (1515. 92 yuan). The hospital days of A,B,C three groups were (11. 3 ± 4. 8) d,(10. 9 ± 10. 6) d,(12. 5 ± 6. 4) d,respectively. The results of MAUT comprehensive evaluation showed that the total score value in polyene phosphatidylcholine group was the highest,and was the optimal treatment in the study. Conclusion Application of MAUT in the study of pharmacoeco-nomics is comprehensive,intuitive and flexible.

Overview of the Mapping Method and Relevant Models in Health Utility Values Measurement / 中国药房

OBJECTIVE:To provide methodological reference for converting non-utility scale measurement results into health utility values. METHODS:Referring to domestic and foreign literatures,mapping methods and relevant models in health utility measurement were summarized. The effect of each model on probability mapping was introduced by taking the Medical outcomes study 12-item short form health survey measurement results converting into the EuroQol group's 5-domain utility values as exam-ple.RESULTS:The mapping methods can be adopted to obtain the health utility values by establishing the mapping relationship be-tween non-utility scale and utility scale. The common models included ordinary least square(OLS)model,censored least absolute deviations(CLAD)model,Tobit model,multinomial Logistic regression(MNL)model,Bayesian networks(BN)model,etc. OLS model was relatively simple with a good predictive validity,but it would be limited by the ceiling effect;Tobit model was not limit-ed by the ceiling or floor effect,when the error term satisfied the variance homogeneity and normality,prediction result of Tobit model was better than OLS model;CLAD model can be used for the situation of Tobit model unsuitable for non-variance homoge-neity of the error term;MNL model firstly determined a health state by regression analysis and then determined its utility value;the prediction validity of BN model was good and it didn't involved many assumptions and restrictions condition in econometrics, but the construction of BN model was greatly influenced by domain experts. Main methods for the calculation of health utility value with MNL or BN model were Monte Carlo simulation method,expected-utility method,most-likely probability methed,etc. We can carry out the model performance evaluation by using the R2,the adjusted R2,the mean error,the mean squared error and the mean absolute error,and then select the optimal model to calculate health utility values. CONCLUSIONS:Due to the advantages and disadvantages of each mapping model,it is necessary to select different mapping models based on the actual conditions.

Overview of the Mapping Method and Relevant Models in Health Utility Values Measurement / 中国药房

OBJECTIVE:To provide methodological reference for converting non-utility scale measurement results into health utility values. METHODS:Referring to domestic and foreign literatures,mapping methods and relevant models in health utility measurement were summarized. The effect of each model on probability mapping was introduced by taking the Medical outcomes study 12-item short form health survey measurement results converting into the EuroQol group's 5-domain utility values as exam-ple.RESULTS:The mapping methods can be adopted to obtain the health utility values by establishing the mapping relationship be-tween non-utility scale and utility scale. The common models included ordinary least square(OLS)model,censored least absolute deviations(CLAD)model,Tobit model,multinomial Logistic regression(MNL)model,Bayesian networks(BN)model,etc. OLS model was relatively simple with a good predictive validity,but it would be limited by the ceiling effect;Tobit model was not limit-ed by the ceiling or floor effect,when the error term satisfied the variance homogeneity and normality,prediction result of Tobit model was better than OLS model;CLAD model can be used for the situation of Tobit model unsuitable for non-variance homoge-neity of the error term;MNL model firstly determined a health state by regression analysis and then determined its utility value;the prediction validity of BN model was good and it didn't involved many assumptions and restrictions condition in econometrics, but the construction of BN model was greatly influenced by domain experts. Main methods for the calculation of health utility value with MNL or BN model were Monte Carlo simulation method,expected-utility method,most-likely probability methed,etc. We can carry out the model performance evaluation by using the R2,the adjusted R2,the mean error,the mean squared error and the mean absolute error,and then select the optimal model to calculate health utility values. CONCLUSIONS:Due to the advantages and disadvantages of each mapping model,it is necessary to select different mapping models based on the actual conditions.

Comparison of Utility Values Measured by Different Instruments / 中国卫生经济

Objective: To compare utility values measured by different instruments. Methods: Different instruments were used to measure utility values in 350 patients who were diagnosed as age-related macular degeneration at the same time. The median of utility values measured by different instruments was regarded as relative standard utility value to process comparison, analysis of variance, correlation analysis and curve estimation. Results: Most differences and correlations among utility values measured by different instruments were significant, as well as equations estimated from relative standard utility value and utility values measured by different instruments, but the degree of fitting was not high. Conclusion: The utility values of the same subject measured by different instruments are quite different. The results of the study could provide correction reference to the utility value measured by single instrument in the absence of absolute standard.