OBJECTIVES:To estimate disparities in quality-adjusted life expectancy (QALE) across social deprivation subgroups in China using the County-level Social Deprivation Index 2020 (CSDI 2020). METHODS:Mortality data from the 2021 Chinese Death Surveillance System were linked with a national EQ-5D-5L health utility survey. Mortality underreporting was calibrated using model life tables and benchmarked against official statistics. Health utilities were modeled using ordinary least squares regression incorporating age-deprivation interactions. QALE was estimated via the Sullivan method. Additional analyses examined the interaction between geographic regions and deprivation quintiles. RESULTS:QALE declined progressively as social deprivation increased. The national QALE gap at birth between the least- and most-deprived quintiles was estimated to be at least 7.73 quality-adjusted life-years (QALYs) (95% CI: 7.12-8.32), with 77.4 QALYs in the least-deprived group versus 69.6 QALYs in the most deprived. Men experienced larger disparities (7.98 QALYs) than women (7.31 QALYs). Sensitivity analyses confirmed a robust gradient, with gaps ranging from 7.45 to 8.71 QALYs. When accounting for region-deprivation interactions, this disparity widened to 10.65 QALYs between the least-deprived Eastern and most-deprived Western subgroups. CONCLUSIONS:Substantial, graded inequalities in QALE exist in China, significantly compounded by regional development gaps. These findings provide a critical empirical foundation for equity-informed health policy and distributional cost-effectiveness analysis.

Health policy aims not only to improve total population health but also to reduce social inequality in health. When these aims conflict, understanding how different stakeholders navigate equity-efficiency trade-offs is critical. This study compared patterns of health inequality aversion among the Chinese general population and health decision-makers. Data were collected from January to April 2025 in a national cross-sectional survey comprising 1001 members of the general population and 80 health decision-makers. Using the Benefit Trade-Off method, respondents evaluated hypothetical programs that improved quality-adjusted life expectancy across income groups. We quantified preferences by estimating inequality aversion parameters where possible and analyzing response distributions and deliberation times. Results show a clear divergence in preferences. The general population exhibited a strongly polarized bimodal pattern, with around one-quarter of respondents at the pro-rich polar extreme and a majority at a lexically egalitarian pro-poor polar extreme that lies beyond finite Atkinson-parameter estimation. By contrast, decision-makers were more likely to have weighted pro-poor ("prioritarian") preferences between these two polar extremes. These differences were not associated with demography, income, or education and decision-makers took substantially longer to complete the trade-off questions. The causes of this divergence are not known, but one potential explanation is that the public tend to focus on one main policy objective whereas decision-makers tend to recognize multiple conflicting policy objectives and seek a compromise. Given this systematic preference divide, institutional mechanisms that combine public participation with deliberative reflection may help reconcile efficiency and equity considerations in health priority-setting.

Linperlisib, a highly selective PI3K-δ inhibitor, was firstly approved in China in November 2022 for the treatment of patients with relapsed or refractory follicular lymphoma (r/r FL) who had received at least two prior lines of systemic therapy (3L+ FL), demonstrating compelling clinical efficacy. This study aimed to evaluate the cost effectiveness of linperlisib compared to duvelisib for patients with 3L+ FL from the perspective of Chinese healthcare system. A lifetime three-state partitioned survival model was developed to integrate comparative efficacy and direct costs. An unanchored matching-adjusted indirect comparison (MAIC) was conducted using individual data from NCT04370405 and published aggregate data from the DYNAMO trial, aiming to derive comparative efficacy data and calculate patients’ life-years gained. Utility values were from GADOLIN study, as neither trial collected them. Quality-adjusted life-years (QALYs) were calculated by multiplying life-years by utility values. Direct costs included costs of drug acquisition, adverse events, subsequent salvage therapy, health-care resource use (HCRU), and end-of-life care. A 5

Despite receiving triple therapy (i.e., long-acting β2-agonist + long-acting muscarinic antagonist + inhaled corticosteroid), patients with chronic obstructive pulmonary disease (COPD) continue to experience exacerbations. This study aimed to investigate the moderate and severe annualized exacerbation rate (AER) and healthcare resource utilization of patients with COPD on triple therapy in China, addressing a significant evidence gap regarding the clinical and economic disease burden in this population. This retrospective cohort study was conducted using the Chongqing Regional Electronic Health Record Database (2018–2022). Patients with COPD aged ≥ 40 years who had received ≥ 3 months of triple therapy during the 12-month baseline period were included. AER, COPD-related hospital visits, length of hospital stay and readmissions, and direct medical costs during the 12-month observation period were analyzed. A total of 6393 patients with COPD on triple therapy were included in the study. Among patients with available data, 17.3

Biologics have significantly enhanced treatment for psoriasis but data regarding their treatment patterns and economic burden are limited. The aim of this study was to evaluate adherence, persistence, switching, health-care resource utilization (HCRU) and costs among secukinumab, adalimumab, ustekinumab, and ixekizumab in China. This retrospective observational study identified adult patients with psoriasis who initiated biologics between 1 January 2020 and 30 June 2022, from the Regional Medical Big Data of Tianjin, China (comprising hospital information system data from 43 tertiary and 39 secondary hospitals). Treatment adherence was assessed using the Proportion of Days Covered (PDC) and PDC ≥ 80

Objective:To evaluate the cost-effectiveness of dupilumab plus background therapy compared with omalizumab plus background therapy in the treatment of severe asthma from the perspective of Chinese health system.Methods:A Markov model was established.The clinical efficacy,health benefit and cost data were obtained from the randomized controlled trials,published literatures and clinical expert consultation results.Lifetime disease outcomes,effectiveness,and costs under each intervention were calculated.With incremental cost-effectiveness ratio(ICER)as the index,the economy of each intervention was evaluated under the threshold of 2 times GDP per capita(178 716 yuan in 2023).Scenario analysis,one way sensitivity analysis and probability sensitivity analysis were carried out to verify the robustness of the results.Results:The total costs were 679 459 and 615 213 CNY in the groups of dupilumab and omalizumab,respectively.Total quality-adjusted life year(QALY)were 13.11 and 12.68.Compared with omalizumab,dupilumab increased costs by 64 246 CNY and QALY by 0.43.ICER was 149661 CNY per QALY,which was lower than the 2 times per-capita GDP threshold,indicating that dupilumab was cost-effective compared with omalizumab.In the two scenarios set in the study,the group of dupilumab was more economical than the group of omalizumab.In the three scenarios set in the study,the group of dupilumab was more economical.If the negotiated price of dupilumab in the 2024 edition of the National Medical Insurance Drug List is used,the group of dupilumab is obviously superior.Sensitivity analysis verified the robustness of the above results.Conclusion:Under the threshold of 2-time Chinese GDP per capita,dupilumab is more cost-effective than omalizumab in the treatment of severe asthma patients.

To compare the performance of matching-adjusted indirect comparison (MAIC) and naïve indirect comparison (NIC) under a wide range of data scenarios on survival outcome. A simulation study included 729 (36) single-arm trial data scenarios, which were created by performing a three-level full factorial arrangement of six situational variables, including individual patient data (IPD) sample size, aggregate data (AgD) sample size, covariate strength, covariate correlation, covariate overlap, and relative treatment effect. In each scenario, 1000 repetitions of simulated datasets were generated using the Monte Carlo approach. MAIC and NIC methods were used to estimate the relative treatment effect of each simulated dataset. The performance was evaluated in terms of bias, empirical standard error (ESE), mean squared error (MSE), and confidence interval coverage, respectively. MAIC yielded relatively unbiased estimates of relative treatment effect compared with NIC in most scenarios, with better coverage and MSE but higher ESE. None of the situational variables had a significant impact on the bias and coverage of MAIC. However, increasing IPD sample size and covariate overlap significantly reduced the ESE and MSE of MAIC. In scenarios with low covariate overlap and high covariate strength, the bias of MAIC was larger and even greater than that of NIC. The performance of MAIC consistently demonstrates advantage over NIC across various scenarios. MAIC often provides more unbiased estimates and achieves confidence interval coverage close to nominal values compared with NIC. While MAIC may exhibit higher ESE in specific scenarios, this additional uncertainty can offer a more accurate reflection of variability, enhancing the robustness of the results. Researchers should thoroughly comprehend the influencing factors and interactions affecting the performance of these methods and judiciously apply research findings.

This study aims to explore hospital responses to incentives under the China Healthcare Security Diagnosis-Related Group (CHS-DRG) system, the first nationwide DRG-based bundled payment initiative in China, which is designed to stimulate the integration of health services and then contain the medical expenditure inflation. Zooming in all insured cases during November 2021 to September 2022, we assessed the impacts of CHS-DRG program under the regional global budget with price adjustment in Tianjin, China upon costs and its underlying mechanism through a difference-in-differences (DID) strategy. A total of 932 354 cases were admitted in the intervention group and 608 940 were in control. Key outcomes included per-admission spending, out-of-pocket payments, reimbursements and total monthly healthcare expenditures from a societal perspective. Additionally, the monthly number of admissions per hospital was analyzed to assess care intensity, while length-of-stay and 30-day readmission rates were employed to examine treatment efficiency and care quality. Robustness checks and common trends tests were performed to validate the findings. The implementation of CHS-DRG led to a significant reduction in per-admission spending by 1.63

BACKGROUND:Chemotherapy-induced myelosuppression (CIM) is the most common adverse event associated with chemotherapy. The recently approved novel pharmacotherapy trilaciclib demonstrates potential to provide multilineage protection against CIM. This study aimed to evaluate the cost-effectiveness of trilaciclib among patients with extensive-stage small cell lung cancer (ES-SCLC) in China. RESEARCH DESIGN AND METHODS:A short-term Markov model and long-term partitioned survival model were developed to simulate disease progression during and after chemotherapy over a lifetime horizon. Clinical, cost, and utility parameters were obtained from three pivotal clinical trials of trilaciclib, published literature, and expert opinion. Total cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated. Scenario analyses and sensitivity analyses assessed model robustness. RESULTS:The lifetime incremental cost per patient for trilaciclib was CN¥22,828 (US$3,210), with an incremental QALY of 0.093, yielding an ICER of CN¥245,841 (US$34,565) per QALY gained. This ICER falls below China's willingness-to-pay threshold of three times per-capita GDP (CN¥268,074, US$37,691). Extensive sensitivity analyses confirmed the robustness of the base-case findings. CONCLUSIONS:Trilaciclib represents a cost-effective option for reducing the incidence of CIM in ES-SCLC patients. These results support reimbursement decisions and pricing strategies for trilaciclib in China.

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare, disabling genetic disorder condition that lacks real-world evidence on disease burden. This study aims to investigate the basic characteristics, diagnostic status, prognosis, economic burden and quality of life of FOP patients in China through self-reported data . An online survey was conducted through the “China Cloud Platform for Rare Diseases” among patients recruited from the FOP patient organization in March 2023. Patient demographic characteristics, diagnosis, prognosis, healthcare resource usage and costs, and health-related quality of life (HRQoL) data were collected. Health-related quality of life was assessed using EQ-5D-Y for children aged 4–15 and EQ-5D-5L for patients aged ≥ 16. Age subgroup analyses for those aged < 8, 8–15, and ≥ 16 were conducted. A total of 67 patients (mean age 16.6 ± 10.2 years, 43.3