PRM5 Systematic Review of Cost-Utility Analyses in Asia

Abstract

PRM5 SYSTEMATIC REVIEW OF COST-UTILITY ANALYSES IN ASIA Lin PJ1, Thorat T1, Fang CH2, Neumann PJ1 1Tufts Medical Center, Boston, MA, USA, 2Pfizer, New Taipei City, Taiwan OBJECTIVES: To review published cost-utility analyses (CUA) targeted towards populations in Asia. METHODS: We examined data from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegisty.org), which contains detailed information on more than 2,900 English-language CUAs in peer-reviewed journals. We focused on articles pertaining to Asian countries, summarized study features for articles published from 2000-2010, and compared those with CUAs in all other countries. RESULTS: Of 2,367 CUAs published during 2000-2010, 87 (3.7%) pertained to Asian countries: Japan (n 34), Taiwan (n 18), China (n 9), Thailand (n 7), Hong Kong (n 5), Singapore (n 5), South Korea (n 5), India (n 4), and Bangladesh (n 1). The CUAs contained 243 standardized incremental cost-effectiveness ratios (ICERs, expressed as $US2010 per QALY) and 357 utility weights. The most common type of intervention was pharmaceuticals (52.9%), followed by screening (21.8%), diagnostics (11.5%), and surgery (11.5%). 79 CUAs (90.8%) mentioned a cost-effectiveness threshold; of these, 60 said “good value for money” reflected a threshold below $50,000/QALY. The median reported ICER was $11,000/ QALY, vs. $21,000/QALY for non-Asian studies. 75.7% of the reported ICERs were either dominant (less expensive and more effective) or below $50,000/QALY, compared to 63.9% in non-Asian CUAs (p 0.001). 13.6% of ICERs were either dominated (more expensive and less effective) or greater than $100,000/QALY, compared to 22.4% in non-Asian CUAs (p 0.001). CUAs targeted towards Asian populations generally adhered to good methodological practices, though the average quality score was modestly lower than the overall mean (4.08 vs. 4.43, p 0.001) and significantly more studies did not report funding sources (40.2% vs. 22.2%, p 0.001), compared with non-Asian CUAs. CONCLUSIONS: The number of CUAs in Asia has grown steadily with over half focused on pharmaceuticals. Compared to CUAs in all other countries, significantly more studies in Asia suggest efficient health interventions. These CUAs generally follow good methodological practices though reporting of funding sources could improve.