ObjectiveTo explore how to determine the attributes of stated preference research more scientifically and reasonably. MethodsBased on the best-worst scaling object case (BWS-1) method, a BWS-1 questionnaire was generated using a balanced incomplete block design. Data collection was conducted among type 2 diabetes mellitus (T2DM) patients in Hainan and Jiangsu provinces. Data analysis was performed using counting analysis and conditional logit model to obtain the priority order of each attribute. ResultsThe results of BWS-1 using the counting and modelling approach showed high consistency. Among the 11 attributes, the top three attributes influencing the preference for second-line antihyperglycemic medications selection in T2DM patients were blood glucose control effectiveness, cardiovascular protection capability, and risk of hypoglycemic events, while the last three factors were dosing frequency, mode of administration and bone fracture. Based on literature review, qualitative research, and BWS-1 results, the seven attributes of discrete choice experiment and best-worst scaling profile case (BWS-2) were determined as follows: treatment efficacy, weight change, hypoglycemic events, gastrointestinal side effects, cardiovascular health, mode of administration and out-of-pocket cost. ConclusionBWS-1 can serve as an effective tool for determining the attributes of stated preference research. However, it is not recommended to solely rely on the priority ranking of BWS-1 results to determine the scope of attributes for stated preference research. It is necessary to conduct a specific analysis in conjunction with the research's policy objectives and real-world circumstances.
Objective To systematically review the health economic evaluations of using long-term rhythm-control antiarrhythmic drugs (AAD) for patients with paroxysmal or persistent atrial fibrillation (AF). Methods Databases including PubMed, EMbase, Scopus, CNKI, SinoMed, WanFang Data, and official websites of well-established health technology assessment (HTA) institutions were electronically searched to present the economic evaluations of AAD and the recommendations of HTA institutions based on drug economy from inception to April 23rd, 2022. Two reviewers independently screened the literature, extracted data and systematic review was then performed. Results A total of 19 studies were included, including 11 cost-effectiveness or cost-utility analysis studies and 8 official documents from HTA institutions. Only 5 (45.5%) economic evaluations were of relatively high quality, and English language studies were of higher quality than Chinese language studies ones. The included studies lacked elements that CHEERS 2022 concerns, such as health economics analysis plans, equity and distributional effects, engagement with patients and other stakeholders and the impact on the study. Dronedarone and amiodarone were the main focus of the evaluation, and the study results showed that dronedarone was cost-effective compared with other drugs in different study designs and national settings. However, there were differences between the recommendations of HTA agencies and the results of economic evaluation studies. Conclusion The completeness of health economics evaluations needs to be improved, along with the quality of clinical evidence in the field of AF-AAD for Chinese patients. Additionally, the informational value of drugs should be thoroughly investigated through budget impact analysis and distributional cost-effectiveness analysis to provide evidence of high-quality studies for decision-makers in China.
Objective This study aimed to quantitatively investigate the preferences and willingness of patients with breast cancer to pay for central venous access and to provide implications for the clinical selection of appropriate chemotherapy pathways. Methods A discrete-choice experiment survey was conducted to elicit the preferences for central venous access in three hospitals in east, middle and west China. The conditional logit model was used to analyse the relative importance of six central venous access-related attributes: risk of thrombosis, risk of infections, restriction of daily activities, maintenance interval, catheter incision size and out-of-pocket costs. Results The valid data for a total of 103 patients was collected from three hospitals. All six attributes significantly influenced patients’ preferences for central venous access. The risk of thrombosis (RIS=26.0%) and risk of infections (RIS=24.3%) were the top two attributes influencing patients’ preferences for central venous access. To reduce the risk of thrombosis and infection from 12% and 8% to 1%, patients were willing to pay 14 861.2 yuan and 13 907.2 yuan, respectively. The catheter incision size was of least concern (RIS=4.6%); the patients were only willing to pay 2 653.6 yuan for smaller catheter incisions. Conclusion Thrombosis and infection are the primary factors that affect the choice of central venous access for patients with breast cancer. Patients have a sensitive trade-off between safety and out-of-pocket costs; with the change in thrombosis and infection risk, patients’ willingness to pay changes accordingly.