To infinity and beyond—three things international donors should consider as health economic evaluation goes global

Imagine you have a budget of £150m (US$193m) to spend in a country where the prevalence of malaria and teenage pregnancy is high, as are the corresponding infant, child and maternal mortality rates. You have three options to spend your money: a programme to distribute bed nets, protecting children against malaria; a programme that expands access to family planning, offering protection to young women; or a salary reform initiative, enabling the Ministry of Health to hire enough staff. You haven’t got enough money to do it all and you need "quick and attributable wins" that avoid negative media on the wastage of money. What would you choose?

Value-based healthcare in Taiwan: Towards a leadership role in Asia - Traditional Chinese

在臺灣,一種價值導向型的醫療策略正逐步引起重視。這是因為該地區的醫療體系面臨創新型治療方法所帶來的機遇和壓力,同時,慢性和傳染性疾病的負擔也在不斷加重。

二十多年的全民健康保險促進了臺灣醫療體系的發展,這有助於研究者獲取一套全面的數據。十多年來,醫療科技評估也在臺灣醫療系統的部分領域中得到了應用。 

然而,人們雖然一直努力將成本效益和對於「價值」更廣泛的計量方法納入到對新的醫療措施的分析和決策中,但迄今為止還沒有做出任何努力來促成對「價值」這一概念的共同理解,或是對醫療保健在這一方面的標準評估方法的接受。 

為了推動確立價值計量的有效方法,臺灣的任何舉措都需要著眼於對價值導向型醫療未來發展至關重要的幾個問題:國家醫療衛生決策機構如何解讀「價值」;參與決策過程的主要利益相關者有哪些,哪些人應該參與到相關決策中;以及在以價值為基礎的這一框架內,醫療保健的哪些方面可以被合理評估。此外,專家認為醫療體系將需要設法利用其醫療科技評估(health technology assessment, HTA)的能力來確定低價值領域,謹慎減少投資,以便為更具成本效益的支出釋放資源。這一過程將需要更多地整合使用HTA來完成包括醫療措施、設備、甚至整個照護路徑在內的多種評估工作。

Value-based healthcare in Taiwan: Towards a leadership role in Asia

Taiwan’s healthcare system benefits from more than 20 years of universal access to healthcare, which has helped to create a comprehensive set of data available to researchers. Health technology assessment has been in place in parts of the system for more than a decade.

Value-based healthcare in Taiwan: Towards a leadership role in Asia

A value-based approach to healthcare is gradually gaining traction in Taiwan, as the country’s healthcare system confronts the opportunities and pressures of innovative new medical treatments along with a growing burden of both chronic and infectious diseases.

日本における“価値に基づく医療”

Value-based healthcare in Japan: An evolving concept

Value-based healthcare in Japan

Value-based healthcare looks at health outcomes of treatment relative to cost. In this particular report The EIU examines whether Japan's healthcare system delivers good value for money, its approach to pricing and reimbursement, and the evolution of a nascent system for health technology assessment (HTA).

Further reading:

Value-based healthcare in Europe: Laying the foundation

Value-based healthcare looks at health outcomes of treatment relative to cost. In this particular report The EIU examines the way in which value is interpreted across the continent, the extent to which European countries are adopting cost-effectiveness as a key criterion for assessing it, and the efforts to develop new models for pricing innovation.

Further reading:

Value-based healthcare in Europe: Laying the foundation

Value-based healthcare looks at health outcomes of treatment relative to cost. In this particular report The EIU examines the way in which value is interpreted across the continent, the extent to which European countries are adopting cost-effectiveness as a key criterion for assessing it, and the efforts to develop new models for pricing innovation.

Further reading:

Value-based healthcare in the UK: A system of trial and error

Value-based healthcare looks at health outcomes of treatment relative to cost. In this particular report The EIU examines the structure of UK healthcare delivery, the unique model used by its health technology assessment (HTA) agencies, and its history of experimentation in value-based pricing.

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