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Health technology assessment and economic evaluation: Is it applicable for the traditional medicine?
Chen Yingyao 한국한의학연구원 2022 Integrative Medicine Research Vol.11 No.1
Gaps between limited health resources and expanding health service demands are emerging to be more and more prominent, which extremely generate the cost-effective strategies for scientific policy-making in the context of healthcare. As a systematic approach and solid tool to promote healthcare system more efficient and sustainable, health technology assessment (HTA) could provide multi-dimensional evidences comprising effectiveness, safety, economic implications, ethical, social, cultural and legal issues, in which economic evaluation is an important and unique part for optimizing decision-making. After decades of development, HTA has formulated a set of systematic theories, methods and procedures based on modern medicine. Meanwhile, as an important component of medicine system across the world, traditional medicine (TM) originates from knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different traditional cultures. Yet whether current theory and method system of HTA is applicable for TM is necessary to be explored and investigated. In principle, the general steps and methods of HTA could be basically applicable to TM, except for the PICO structuring, cost measurement, and supportive clinical evidence and information collection in economic evaluation. Therefore, these three challenging problems need to be focused and addressed in future HTA for TM.
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Teng Yue,Wei Yan,Chen Yingyao,Yan Juntao,Liu Shimeng,Li Fuming,Bao Shiyi,Ren Yanfeng,Liu Liu,Yang Yi 한국한의학연구원 2023 Integrative Medicine Research Vol.12 No.3
Background: Traditional Chinese Medicine (TCM), integrating patient preferences into decision-making process, has been widely used in the multimodality therapy of lung cancer. This study aimed to estimate patient preferences for treatment and shared decision-making (SDM) modes concerning inpatient TCM treatment of lung cancer in Shanghai in order to provide a basis for clinical decision-making process on TCM therapy for lung cancer. Methods: This study was conducted among patients (n = 347) from nine tertiary hospitals in Shanghai by discrete-choice experiment (DCE) survey and Shared Decision-Making Questionnaire-patient version (SDM-Q-9) survey. The DCE was developed with the inclusion of the most relevant attributes at appropriate levels for the TCM treatment of lung cancer. The empirical data analyses of patients were performed using mixed logit models. Additionally, subgroup analysis was conducted. Results: In total, 347 respondents completed the questionnaire. All attributes’ coefficients were statistically significant for patients’ preferences. Patients showed strong preferences for increasing disease control rate, relieving nausea and vomiting, reducing the risk of side effects, and were concerned about monthly out-of-pocket costs. Subgroup analysis indicated that patients with a lower SDM-Q-9 score and those who were satisfied with medical services emphasized more importance of higher disease control rate. Furthermore, most of the patients (90.20%) self-reported a high willingness to use SDM during the decision-making process. Conclusion: In Shanghai, patients mainly preferred SDM and considered disease control rate as the most essential attribute in the TCM treatment of lung cancer. The study findings could underscore the importance of considering patients’ preferences and promote SDM.
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Yan Juntao,Bao Shiyi,Liu Liu,Zhang Yu-Qing,Ming Jian,Wei Yan,Chen Yingyao 한국한의학연구원 2023 Integrative Medicine Research Vol.12 No.1
Background: Traditional Medicine (TM) has a wide uptake in most countries. In China, Traditional Chinese Medicine (TCM) is a common kind of primary health because of its beneficial effects. This review aimed to appraise the publication reporting quality of economic evaluations for selective TCM in the National Reimbursement Drug List (NRDL), Version 2020, based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Methods: Electronic databases were searched for economic evaluation that supported the TCM negotia- tions in NRDL (2020 version) published from 2001 to 2021, including PubMed, Web of Science, Embase, CNKI, WanFang, and SinoMed. The CHEERS statement was used to appraise the reporting quality of in- cluded TCM economic evaluations. Results: A total of 360 articles were retrieved, but only 38 economic evaluations met the inclusion crite- ria. None of the articles reported all items in the CHEERS checklist. The mean score of included articles is low at 10.93 ±2.62, with an average scoring rate of 51.31 ±10.53%. The least reported items included: “Characterizing heterogeneity,”“Conflicts of interest”, “Discount rate,”and “Study perspective,”with a re- porting rate of 0.00%, 5.26%, 7.89%, and 15.79%, respectively. Conclusion: An upward trend occurred in the quantity and quality of the economic evaluation publica- tions of TCM in China. TCM economic evaluations are still at an early stage, with an urgent need for improving reporting quality. It may result from research experiences or different ideas between TCM and Western Medicine. Adhering to reporting guidelines like CHEERS and educating economic evaluation in- vestigators can improve TCM economic evaluations’ reporting quality.
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