Examining Equity Effects of Health Interventions in Cost-Effectiveness Analysis: A Systematic Review

被引:55
作者
Avancena, Anton L., V [1 ]
Prosser, Lisa A. [1 ,2 ]
机构
[1] Univ Michigan, Sch Publ Hlth, Dept Hlth Management & Policy, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Susan B Meister Child Hlth Evaluat & Res CHEAR Ct, Med Sch, Dept Pediat, Ann Arbor, MI 48109 USA
关键词
distributional cost-effectiveness analysis; equity-informative cost-effectiveness analysis; equity weighting; CONTEXT-FREE EXPERIMENTS; EFFICIENCY TRADE-OFF; PEOPLES PREFERENCES; POLICY-MAKERS; PUBLIC-HEALTH; CARE; PRIORITY; CANCER; AGE; FRAMEWORK;
D O I
10.1016/j.jval.2020.10.010
中图分类号
F [经济];
学科分类号
02 ;
摘要
Objective: This systematic review aims to catalogue and describe published applications of equity-informative costeffectiveness analysis (CEAs). Methods: Following PRISMA guidelines, we searched Medline for English-language, peer-reviewed CEAs published on or before August 2019. We included CEAs that evaluated 2 or more alternatives; explicitly mentioned equity as a consideration or decision-making principle; and applied an equity-informative CEA method to analyze or examine at least 1 equity criterion in an applied CEA. We extracted data on selected characteristics and analyzed reporting quality using the CHEERS checklist. Results: Fifty-four articles identified through a search and bibliography reviews met the inclusion criteria. All articles were published on or after 2010, with 80% published after 2015. Most studies evaluated primary prevention interventions in disease areas such as cancer, infectious diseases, and cardiovascular disease. Equity impact analysis alone was the most common equity informative CEA (56%), followed by equity impact analysis with financial protection effects (30%). At least 11 different equity criteria have been used in equity-informative CEAs; socioeconomic status and race/ethnicity were used most frequently. Seventy-eight percent of studies reported finding "greater value" in an intervention after examining its distributional effects. Conclusion: The number of equity-informative CEAs is increasing, and the wide range of equity criteria, diseases, interventions, settings, and populations represented suggests that broad application of these methods is feasible but will require further refinement. Inclusion of equity into CEAs may shift the value of evaluated interventions and can provide crucial additional information for decision makers.
引用
收藏
页码:136 / 143
页数:8
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