Evidence map›Paper›PMID 39663916›Full record

ArticleInternational journal of technology assessment in health care2024

Case studies of health economic analyses informing pharmaceutical health technology assessments for essential medicine selection and public-sector guidelines in South Africa.

Trudy D Leong, Jacqui Miot, Andy Parrish, Jane Riddin, Yasmina Johnson, Tamara Kredo

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Article in International journal of technology assessment in health care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

6 authors.

Trudy D LeongHealth Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.ORCID https://orcid.org/0000-0003-2687-7751
Jacqui MiotHealth Economics and Epidemiology Research Office, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.ORCID https://orcid.org/0000-0001-7070-3826
Andy ParrishWalter Sisulu University, Mthatha, South Africa; Frere and Cecilia Makiwane Hospitals, East London, South Africa.
Jane RiddinNational Department of Health, Affordable Medicines Directorate, Essential Drugs Programme, Pretoria, South Africa.
Yasmina JohnsonWestern Cape Government Health and Wellness, Western Cape, South Africa.
Tamara KredoHealth Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConstrained resources under universal health coverage (UHC) necessitate a balance between medication costs and essential health system requirements. Policymakers practice priority-setting, as either implicit or explicit rationing, embedded in evidence-informed decision-making processes to guide funding decisions. Health technology assessment (HTA) is a method that may assist explicit evidence-informed priority setting. South Africa developed an official HTA methods guide in 2022, however before this, commissioning and performing economic evaluations was not standardized.

methodsWe conducted a descriptive collective case study to explore the impact of economic analyses on the selection of, and access to, essential medicines in South Africa. Four cases were purposefully selected, and both official information and secondary data, including media reports, were reviewed. Data elements were extracted and organized in a matrix. Cases were reported narratively with a positivist epistemological approach, presenting the authors' reflections.

resultsWe found economic analyses that reflected methodologies described in the HTA guide: international reference pricing, cost-minimization, cost-effectiveness, cost-utility, and budget impact analyses. Economic analyses informing the 'resource-use' domain in the GRADE evidence-to-decision framework supported decision-making, influenced market-shaping with price reductions of interventions through benchmarking (fosfomycin, flucytosine), improved equitable access nationally (flucytosine), and prioritized a defined patient group in a justifiable and transparent manner (bortezomib).

conclusionA standardized HTA evaluation process guided by a nationally accepted framework is necessary for evidence-informed decision-making. Economic analyses (cost-effectiveness, affordability, and resource use) should be consistently included when making decisions on new interventions.

Indexed as

Cost-Benefit AnalysisDrugs, EssentialTechnology Assessment, BiomedicalDecision MakingHumansPublic SectorSouth AfricaUniversal Health InsuranceDrugs, Essentialclinical guidelineseconomic analysisessential medicineshealth technology assessmentuniversal health coverage

Identifiers

PMID39663916
PMCPMC11703611

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.