Methodological Approaches and Current Applications of Distributed Cost-Effectiveness Analysis: A Systematic Review
Author(s)
Jiaqi Shi, Bachelor1, Qinqiu Wang, Bachelor1, Ming Hu, PhD2;
1West China School of Pharmacy, Sichuan University, Chengdu, China, 2West China School of Pharmacy, Sichuan University, Professor, Chengdu, China
1West China School of Pharmacy, Sichuan University, Chengdu, China, 2West China School of Pharmacy, Sichuan University, Professor, Chengdu, China
Presentation Documents
OBJECTIVES: This study aims to comprehensively collect literature that utilizes distributed cost-effectiveness analysis (DCEA) for equity evaluation of health intervention programs. It summarized the research methods and status applications of DCEA, providing a reference for conducting health economic evaluation that incorporates considerations of health equity.
METHODS: We conducted a search of both Chinese and English databases, including PubMed and CNKI. The search period was set from the inception of each database to April. We excluded abstracts, comments, and general reviews. Literature was methodologically assessed using the NICE economic evaluation checklist. We extracted details such as the study region, subjects, perspectives, disease types, subgroup classification criteria, intervention measures, health outcome indicators, equity measurement methods, and sensitivity analysis.
RESULTS: 508 references were identified, with 14 studies meeting the criteria. The majority of the studies were published after 2018 (71.4%). The overall quality of the included studies was high, with 11 studies (78.6%) having a full compliance rate of over 70% and being rated as "partially limited". The research regions were mainly concentrated in developed countries, such as the United Kingdom, the United States, and South Korea, with only four studies (28.6%) conducted in developing countries like Ethiopia and Malawi. The study subjects were diverse, primarily including patients (28.6%), the general population (28.6%), and children (21.4%). The most common disease type was cancer (35.7%), followed by infectious diseases (21.4%). Regarding subgroup classification criteria, socioeconomic differences (42.9%) and race (35.7%) were of particular interest. Additionally, nine studies (64.3%) used quality-adjusted life years (QALY) as the main health outcome measure.
CONCLUSIONS: DCEA can effectively balance the cost-effectiveness and health equity of health interventions. However, DCEA also has certain limitations, and future research should further focus on and improve aspects such as data collection, methodological advancements, and the definition of equity.
METHODS: We conducted a search of both Chinese and English databases, including PubMed and CNKI. The search period was set from the inception of each database to April. We excluded abstracts, comments, and general reviews. Literature was methodologically assessed using the NICE economic evaluation checklist. We extracted details such as the study region, subjects, perspectives, disease types, subgroup classification criteria, intervention measures, health outcome indicators, equity measurement methods, and sensitivity analysis.
RESULTS: 508 references were identified, with 14 studies meeting the criteria. The majority of the studies were published after 2018 (71.4%). The overall quality of the included studies was high, with 11 studies (78.6%) having a full compliance rate of over 70% and being rated as "partially limited". The research regions were mainly concentrated in developed countries, such as the United Kingdom, the United States, and South Korea, with only four studies (28.6%) conducted in developing countries like Ethiopia and Malawi. The study subjects were diverse, primarily including patients (28.6%), the general population (28.6%), and children (21.4%). The most common disease type was cancer (35.7%), followed by infectious diseases (21.4%). Regarding subgroup classification criteria, socioeconomic differences (42.9%) and race (35.7%) were of particular interest. Additionally, nine studies (64.3%) used quality-adjusted life years (QALY) as the main health outcome measure.
CONCLUSIONS: DCEA can effectively balance the cost-effectiveness and health equity of health interventions. However, DCEA also has certain limitations, and future research should further focus on and improve aspects such as data collection, methodological advancements, and the definition of equity.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
SA9
Topic
Study Approaches
Topic Subcategory
Literature Review & Synthesis
Disease
No Additional Disease & Conditions/Specialized Treatment Areas