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Tytuł:
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Do Social Values and Institutional Context Shape the Use of Economic Evaluation in Reimbursement Decisions? An Empirical Analysis.
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Autorzy:
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Torbica A; Centre for Research on Health and Social Care Management, Bocconi University, Milan, Italy. Electronic address: .
Fornaro G; Centre for Research on Health and Social Care Management, Bocconi University, Milan, Italy.
Tarricone R; Centre for Research on Health and Social Care Management, Bocconi University, Milan, Italy.
Drummond MF; Centre for Health Economics, University of York, York, England, UK.
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Źródło:
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Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research [Value Health] 2020 Jan; Vol. 23 (1), pp. 17-24. Date of Electronic Publication: 2019 Dec 10.
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Typ publikacji:
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Comparative Study; Journal Article; Review
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Język:
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English
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Imprint Name(s):
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Publication: Jan./Feb. 2011- : New York : Elsevier
Original Publication: Malden, MA : Blackwell Science, c1998-
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MeSH Terms:
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Choice Behavior*
Health Care Costs*
Social Values*
Health Care Rationing/*economics
Health Policy/*economics
Technology Assessment, Biomedical/*economics
Clinical Decision-Making ; Health Care Rationing/organization & administration ; Humans ; Organisation for Economic Co-Operation and Development ; Policy Making ; Technology Assessment, Biomedical/organization & administration
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Contributed Indexing:
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Keywords: cost-effectiveness analysis; economic evaluation; healthcare decision making; institutional context; social values
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Entry Date(s):
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Date Created: 20200119 Date Completed: 20200622 Latest Revision: 20200622
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Update Code:
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20240104
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DOI:
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10.1016/j.jval.2019.11.001
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PMID:
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31952668
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Objectives: To investigate whether the use of economic evaluation (EE) in healthcare decision making is influenced by the social values and institutional context in a given country.
Methods: We developed and tested a conceptual framework for the 36 Organisation for Economic Co-operation and Development (OECD) countries. The countries were divided into two groups based on the extent of their use of EE in drug reimbursement. The key social values were efficiency, equity, and personal responsibility, measured in an international survey. Countries were classified based on their institutional context in terms of their general welfare paradigm/type of healthcare system and the administrative tradition to which they belong. We performed correlation tests and ran path analysis regression models to test our hypotheses.
Results: EE high users included significantly more Beveridge-type systems (50% vs 31%) and fewer Bismarck-type (15% vs 56%). Napoleonic tradition countries seemed to reject personal responsibility in health (r = -0.511, P = .009), whereas Germanic tradition countries embraced it (r = 0.572, P = .003); Anglo-American tradition countries exhibited a significant association with efficiency (r = 0.444, P = .026), whereas Scandinavian tradition countries appeared to reject it as a criterion for rationing in healthcare (r = -0.454, P = .023). No significant direct association was found between social values and use of EE.
Conclusion: Our exploratory analysis suggests that institutional context and, indirectly, social values may play a role in shaping the use of EE in healthcare decision making. Because of the differences among countries in terms of institutional context, which may in part be influenced by social values, it is unlikely that there will ever be a single, harmonious approach to the use of EE.
(Copyright © 2019 ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
