Background: The healthcare sector is evolving while life expectancy is increasing. These trends put greater pressure on healthcare resources, prompt healthcare reforms, and demand transparent arguments and criteria to assess the overall value of health interventions. There is no consensus on the core criteria by which to value and prioritize interventions, and individual stakeholders might value specific elements differently. The present study is based on a literature review that retrieved the most widely recognized arguments and criteria used in decision-making. The aim was to compile a smaller set of arguments and criteria that would seem most relevant to different stakeholders. Methods: A literature review was performed in Medline and EMBASE. The initial search retrieved over 2000 articles and documents of relevant committees. A selection was made based on their reference to healthcare, policy issues, or social justice. Finally, 84 papers were included. Data extraction took place after appraisal of the articles. A full table was made, including all arguments and criteria found; next, identical or largely overlapping arguments were excluded. The remaining arguments and criteria were assessed for relevance and a reduced set was compiled. Results: The final set included 25 arguments and criteria, categorized by type (clinical, social justice, ethical, and policy). For each argument and criterion, relevance to stakeholders was scored on three levels (not, partly, and completely relevant). Conclusions: Many arguments and criteria play a role in making value judgments on health interventions, but not all are relevant to all interventions. Moreover, they may interact with each other. A viable way to deal with interacting and possibly conflicting arguments and criteria might be to arrange public discussions that would evoke different stakeholders' perspectives.
STAT. RESULTS: The total of 132,846 patients met inclusion criteria. Generic Dispense Rate (GDR) increased by 5.9% (pϽ0.001) in the CDHP cohort compared to the 4.7% (pϽ0.001) increase in the Traditional cohort between the pre and post periods. No significant differences were observed in the 90-day supply distribution between the two cohorts. Observed (unadjusted) 12-months adherence did not change significantly post CDHP implementation in the 4 key therapeutic classes: STATINS, ACEIs, ARBs, and BIGUANIDES. The utilization of PPIs decreased postimplementation by 0.34% (pϽ0.05) in the CDHP cohort, while it increased by 2.5% (pϽ0.001) in the Traditional cohort. CONCLUSIONS: CDHP members were observed to behave in a cost-effective manner. Post-implementation increase in GDR in the CDHP cohort was 1.2% (pϽ0.001) higher compared with the members in the Traditional cohort. The CDHP cohort demonstrated decreased utilization of some nonessential medications, but their observed adherence to key therapies was unaffected.
Intra class correlation coefficients between the countries were high: from 0.89 (England vs. US) through 0.99 (Canada vs. US). ConClusions: This proof of concept study indicates that computer-based choice tasks for the EQ-5D-5L in the general population are feasible and parameter of the choice tasks estimates are generally consistent and logical, and the estimated values are largely consistent between the 4 countries. PP3 Can the Use of soCial Media and Mobile aPPs iMProve Patient Knowledge of disease and health oUtCoMes? a systeMatiC review
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