Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical...Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical trial conducted in Asia. Methods: We applied a Markov model to estimate the quality-adjusted life years, medical cost and incidence of diabetes-related complications for patients receiving the Liraglutide as an add-on to the metformin treatment. Baseline characteristics were taken from a China’s study while the treatment effect is from an Asian study. The related medical cost and utility score were obtained from a local study in China. Having set 30 years’ simulations, the incremental cost-effectiveness ratio was calculated comparing with glimepiride treatment. The ratio would be compared with the willingness to pay for a quality-adjusted-life-year (QALY) which is three times of the GDP per capita in Beijing. Sensitivity analysis was also performed. Result: During a period of 30 years, the base-case analysis which takes discount rate at 3% shows that Liraglutide 1.8 mg results in an average incremental cost of CNY 82,671.49, an improvement in 0.12 QALYs and a reduction of incidence of diabetes-related complications comparing to glimepiride. The associated incremental cost-effectiveness ratio is CNY 688,929.08. Conclusion: Long-term project shows that taking Liraglutide as an add-on to the metformin treatment will lead to increasing quality-adjusted life years and reduction of incidence of diabetes-related complications. When the price of Liraglutide is reduced by 43 percent in China’s yuan, Liraglutide will be cost-effective in China from the healthcare system perspective taking three times of GDP per capita as our WTP threshold.展开更多
This paper is an exploration into the practice of narrative medicine in the clinical setting guided by the theory and approaches of traditional Chinese medicine(TCM).By adopting the theory of TCM,the author attempted ...This paper is an exploration into the practice of narrative medicine in the clinical setting guided by the theory and approaches of traditional Chinese medicine(TCM).By adopting the theory of TCM,the author attempted to provide the patients with systematic treatment from the perspective of society-psychology-biology under the guidance of both the unity of Heaven and Man,and the unity of Xing(Body)and Shen(Mind/Spirit)through his clinical practice.Guided by yin-yang and Wu Xing(Five Elements)theory and focusing on the social relations of the patients for any possible relationships between patients’social,psychological and biological state,the author took the patients’emotion management as a point of departure and helped the patients recover both physically and psychologically by promoting positive transformation in patients’social,psychological,and biological state.A clinical case was provided at the end of this paper to demonstrate how the above theory was put into practice.Narrative medicine under the guidance of TCM theory can supplement modern medical humanity practices as well as extend the scope of modern medical treatment from the perspective of the unity of Heaven and Man,by enriching the content of narrative medicine,and promoting the medical model from biological medical model toward social-psychological-biological model.展开更多
2024年7月,国家医保局发布《关于印发按病组和病种分值付费2.0版分组方案并深入推进相关工作的通知》,标志着我国疾病诊断相关分组(diagnosis related group,DRG)支付改革正式迈入2.0时代。2.0版分组方案中,DRG增加了6组,核心DRG增加了3...2024年7月,国家医保局发布《关于印发按病组和病种分值付费2.0版分组方案并深入推进相关工作的通知》,标志着我国疾病诊断相关分组(diagnosis related group,DRG)支付改革正式迈入2.0时代。2.0版分组方案中,DRG增加了6组,核心DRG增加了33组,具有分组更科学合理、更契合临床实际情况的特点。国家医保局同步明确了5个配套管理机制,即特例单议机制、基金预付机制、谈判协商机制、意见收集反馈机制和数据公开机制,旨在优化DRG支付改革管理,确保医疗机构、医保部门和患者实现多方共赢。2.0版的发布,为医疗机构提供了更精细化的管理工具和更合理的支付机制。医疗机构应积极拥抱该项改革,通过优化内部管理和提高服务质量,实现成本控制和效率提升,最终达到患者、医保基金和医疗机构三方共赢。展开更多
从比较研究视角出发,对国内三种中医医保支付方式改革的典型模式进行分析,为后续优化中医医保支付方式提供依据与参考。南京市推行中医按疾病诊断相关分组(Diagnosis Related Groups,DRG)付费,柳州市推行中医优势病种按疗效价值付费,杭...从比较研究视角出发,对国内三种中医医保支付方式改革的典型模式进行分析,为后续优化中医医保支付方式提供依据与参考。南京市推行中医按疾病诊断相关分组(Diagnosis Related Groups,DRG)付费,柳州市推行中医优势病种按疗效价值付费,杭州市推行基于“中治率”的中医医疗服务支付倾斜政策。三地先行先试,做法各异,形成不同的中医医保支付改革模式,在促进中医药事业发展中发挥先锋模范作用。通过比较得出,中医医保支付方式改革需要抓住中医“优势”本质,结合各地实际推出体现中医元素、多路径结合的付费方式,促进中医药事业发展和中医医院高质量发展。展开更多
文摘Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical trial conducted in Asia. Methods: We applied a Markov model to estimate the quality-adjusted life years, medical cost and incidence of diabetes-related complications for patients receiving the Liraglutide as an add-on to the metformin treatment. Baseline characteristics were taken from a China’s study while the treatment effect is from an Asian study. The related medical cost and utility score were obtained from a local study in China. Having set 30 years’ simulations, the incremental cost-effectiveness ratio was calculated comparing with glimepiride treatment. The ratio would be compared with the willingness to pay for a quality-adjusted-life-year (QALY) which is three times of the GDP per capita in Beijing. Sensitivity analysis was also performed. Result: During a period of 30 years, the base-case analysis which takes discount rate at 3% shows that Liraglutide 1.8 mg results in an average incremental cost of CNY 82,671.49, an improvement in 0.12 QALYs and a reduction of incidence of diabetes-related complications comparing to glimepiride. The associated incremental cost-effectiveness ratio is CNY 688,929.08. Conclusion: Long-term project shows that taking Liraglutide as an add-on to the metformin treatment will lead to increasing quality-adjusted life years and reduction of incidence of diabetes-related complications. When the price of Liraglutide is reduced by 43 percent in China’s yuan, Liraglutide will be cost-effective in China from the healthcare system perspective taking three times of GDP per capita as our WTP threshold.
文摘This paper is an exploration into the practice of narrative medicine in the clinical setting guided by the theory and approaches of traditional Chinese medicine(TCM).By adopting the theory of TCM,the author attempted to provide the patients with systematic treatment from the perspective of society-psychology-biology under the guidance of both the unity of Heaven and Man,and the unity of Xing(Body)and Shen(Mind/Spirit)through his clinical practice.Guided by yin-yang and Wu Xing(Five Elements)theory and focusing on the social relations of the patients for any possible relationships between patients’social,psychological and biological state,the author took the patients’emotion management as a point of departure and helped the patients recover both physically and psychologically by promoting positive transformation in patients’social,psychological,and biological state.A clinical case was provided at the end of this paper to demonstrate how the above theory was put into practice.Narrative medicine under the guidance of TCM theory can supplement modern medical humanity practices as well as extend the scope of modern medical treatment from the perspective of the unity of Heaven and Man,by enriching the content of narrative medicine,and promoting the medical model from biological medical model toward social-psychological-biological model.
文摘2024年7月,国家医保局发布《关于印发按病组和病种分值付费2.0版分组方案并深入推进相关工作的通知》,标志着我国疾病诊断相关分组(diagnosis related group,DRG)支付改革正式迈入2.0时代。2.0版分组方案中,DRG增加了6组,核心DRG增加了33组,具有分组更科学合理、更契合临床实际情况的特点。国家医保局同步明确了5个配套管理机制,即特例单议机制、基金预付机制、谈判协商机制、意见收集反馈机制和数据公开机制,旨在优化DRG支付改革管理,确保医疗机构、医保部门和患者实现多方共赢。2.0版的发布,为医疗机构提供了更精细化的管理工具和更合理的支付机制。医疗机构应积极拥抱该项改革,通过优化内部管理和提高服务质量,实现成本控制和效率提升,最终达到患者、医保基金和医疗机构三方共赢。
文摘从比较研究视角出发,对国内三种中医医保支付方式改革的典型模式进行分析,为后续优化中医医保支付方式提供依据与参考。南京市推行中医按疾病诊断相关分组(Diagnosis Related Groups,DRG)付费,柳州市推行中医优势病种按疗效价值付费,杭州市推行基于“中治率”的中医医疗服务支付倾斜政策。三地先行先试,做法各异,形成不同的中医医保支付改革模式,在促进中医药事业发展中发挥先锋模范作用。通过比较得出,中医医保支付方式改革需要抓住中医“优势”本质,结合各地实际推出体现中医元素、多路径结合的付费方式,促进中医药事业发展和中医医院高质量发展。
