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Objective@#To evaluate the cost-effectiveness of seasonal influenza vaccination, compared to no vaccination, for the elderly aged ≥60 years old in China.@*Methods@#A static life-time Markov model is conducted to simulate the Chinese elderly population aged ≥60 years old. Taking the health care system perspective, one-year analytic cycle length is used for each influenza season. The model was assumed to be repeated until the individual reaches 100 years old. Three interventions were evaluated, including no vaccination, annual trivalent influenza vaccination, and annual quadrivalent influenza vaccination. Using the threshold of 3 times GDP per capita per Quality-adjusted life year (QALY) (193 932/QALY), the incremental cost-effectiveness ratio (ICER) was calculated to compare the cost-effectiveness of every two interventions.Model inputs like data for costs and utilities were from studies on Chinese population if they were available. QALY was used to measure health utility. One-way sensitivity analysis and probabilistic sensitivity analysis were adopted to quantify the level of confidence of the model output.@*Results@#The total influenza associated costs of no vaccination would be 603 CNY per person, while the total costs of annual trivalent vaccination would be 1 027 CNY. Using trivalent vaccine would result in 0.007 QALY gained per person compared to no vaccination, with an increased cost of 424 CNY per person. The ICER of trivalent vaccination over no vaccination for all the elderly population in China would be 64 026 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. The total costs of annual quadrivalent vaccination would be 1 988 CNY. Using quadrivalent vaccine would result in 0.008 additional QALY gained per person compared to no vaccination, with an increased cost of 1 385 CNY per person. The ICER of quadrivalent vaccination over no vaccination would be 174 081 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita.@*Conclusion@#Vaccinating elderly population would improve health utilities at higher health care costs for the elderly. Using the threshold of 3 times GDP per capita per QALY (193 932/QALY), both trivalent and quadrivalent vaccination would be cost-effective compared to no vaccination in elderly Chinese population.
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OBJECTIVE:To investigate the effectiveness and economy of Xinmailong injection combined with basic treatment plan in the treatment of heart failure with reduced left ventricular ejection fraction (HFREF).METHODS:In prospective randomized central group and open programmatic clinical trials,HFREF patients enrolled in 27 general hospitals during Feb.2014-Nov.2016 were divided into control group (n=253) and trial group (n=872) according to 1∶3.Control group received basic treatment,while trial group was additionally given Xinmailong injection intravenously for a treatment course (5 d) at least.Cost-effectiveness analysis was conducted from the perspective of the whole society by using the total response rate of cardiac functional grading,left ventricular ejection fraction (LVEF) improved data,Minnesota heart failure quality scale (MLHFQ) improved data and re-hospitalization rate.RESULTS:Total response rates of cardiac functional grading in control group and trial group were 61.54％ and 81.06％ in 3 months.The improved data of LVEF were about 3.05％ and 7.35％;MLHFQ improved data were 24.39 and 26.63,and re-hospitalization rates were 19.43％ and 10.02％.There were statistical significance in 2 groups (P＜0.05),which indicated that clinical efficacy of trial group was better than that of control group.Pharmacoeconomics results showed that cost-effectiveness ratio of positive indicators as the improved data of LVEF and chronic cardiac insufficiency QOL scale (MLHFQ) in trial group were lower than control group (189.35 vs.243.46,576.38 vs.614.29).The cost-effectiveness ratio of re-hospitalization rate and fatality rate in trial group were higher than control group (2 019.61 vs.925.42).CONCLUSIONS:Xinmailong injection combined with basic treatment plan is better than basic treatment plan in the treatment of HFREF,and shows a better economy in cost-effectiveness analysis.
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Object:The paper aims to analyze Taiwanese experience in pharmaceutical procurement, pharma-ceutical benefits and reimbursement schedule, and make references for the Mainland China. Methods:Through read-ing and analyzing the Taiwanese government policy and the literature published to find out the pharmaceutical pro-curement measures, different medicines’ pricing strategy and its reimbursement mode compared with the Mainland China. Results: Hospitals can purchase medicines based on their own needs, and the purchase price was formed through negotiating with providers and buyers. It has been found that Taiwan only controls the medicines reimburse-ment prices. The international reference pricing is adopted for new medicines, and the originators, bioequivalence/bioavailability generic medicines and general generics reimbursement prices are very high at international reference prices, and need to be weakened in order to fit the requirements. Moreover, the medicine quality is one of the stand-ards considered in case of making decisions on the reimbursement prices. In addition, the reimbursement price is as-sociated with procurement price. When the spread is larger than 30%, the government will adjust the reimbursement to fill the gap. Conclusions: Through the system design and adjustment, the Taiwanese Government have set up a better procurement and reimbursement co-ordination in the pharmaceutical segment, and formed the reasonable prices for the case. The Taiwanese experience can be taken as a reference for the mainland China to refine its procurement reforms and reimbursement policy.
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The paper studied the development opportunities and challenges faced by private hospitals during the ongoing health reform and reviewed the milestones of such hospitals in China.In addition,it compared the developments of both private hospitals and public hospitals since the reform,analyzed the advantages and disadvantages.Based on such analysis,the paper proposed such business strategies as group strategy and differentiation strategy,pointing the way for further development of private hospitals.
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Objective To evaluate the impacts of the essential medicine system in Jiangsu Province on rational drug use in community health service centers.Methods 7667 outpatient prescriptions from 6 community health service centers in Nantong were selected by cluster sampling from January 2009 to December 2011,the part of SDUIs(Selected Drug Use Indicators)developed by WHO and the self-design indicators were employed to analyze rational use of drugs.Results After implementation of the essential medicine system,the average types of drugs per prescription decreased from 3.02 to 2.74,the rate of antibiotic drugs usage dropped from 61.43％ to 51.2％,the rate of one antibiotic usage reduced from 33.94％to 28.58％,and two types from 20.43％to 15.8％,all with significant differences(P＜0.001).The average expenses in single prescription arose from RMB 69.70 to 87.28,the rate of essential medicine usage increased from 81.22％to 85.60％,the injection utilization decreased from 31.14％ to 14.13％,while TCM utilization ascended from 16.17％to 21.8％,all with significant differences(P＜0.001).Condusion The essential medicine systems has positive impacts on rational drug use,but the expenses of per prescription are higher,and irrational antibiotic drugs are still a serious problem.
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Objective: To analyze the status and general trend of urban residents’ health equity and health performance. Methods:Adopting standardization of concentration index, the extended concentration index and health performance index. Results: Chronic disease and self-assessed health of urban residents in China gradually improved from 2007 to 2011, while disability of those people did not improve significantly. Health inequity exists among urban residents with different incomes. Chronic disease and disability are inclined to the poor while self-assessed health is inclined to the rich, but the unfair degree has decreased gradually by year; the self-assessed health and the health performance of chronic disease has been improved from the comprehensive health level and equity, the disability sustains serious condition. Conclusion: China’s new health care reform does not significantly improve the domestic urban residents’ health equity and health performance, the objective set of the health care reform in China should pay more attention to health equity.
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Objective To accurately understand multi-spot medical practice in China and evaluate its effect.Methods Operation data of 2008 and 2009 were gathered from all medical institutions in Kunming to analyze the effect of the practice trial using the fixed effect model.Results Under control of such factors as the scale and type of the hospitals,clinic visits of the second certified hospital benefited by the practice increased by 14％than before,whereas the medical revenue of the institution increased by 29％.The effect proves more significant in terms of total clinic visits and medical revenues at level-1 and level-2 medical institutions.Conclusion Multi-spot medical practice in Kunming proves successful as it increased medical service supply and medical revenue,especially for level-1 and level-2 medical institutions.This effect possibly results from releasing high-level physicians down to lower-level institutions,helping these institutions to attract patients.
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Clinical observation was carried out in 12 patients with chronic heart failure refractory to digitalis, diuretics and vasodilators. Polysaccharide sulfact tablets were given for 15 days. Results showed that improvement of heart function was found in 8 cases, among which 5 cases were excellent and 3 cases fine. The overall clinical effective rate was 66. 7%. The drug had the faveorable effects to decrease blood viscosity, imporve microcirculation. etc. We consider that PSS may be used as a suplementary drug to treat CHF.