PDF(Pubmed)
Abstract：
BACKGROUND: Evaluating healthcare interventions for their impacts beyond health outcomes may result in recognition of changes in human capital, income level, tax revenue, and government spending, which could affect economic growth and population health. In this paper, we document instances where current health technology assessment (HTA) practices fail to account for the impacts of healthcare interventions on broader society beyond the healthcare sector.
METHODS: We propose a novel conceptual framework, highlighting its three components (distributional cost-effectiveness analysis [DCEA], input-output model, and voting scheme) and their contributions to capturing the economic and societal ripple effects of healthcare interventions. This manuscript also outlines a case study in which the framework is applied to the reassessment of a previously evaluated digital health therapeutic for the treatment of opioid use disorder (OUD) compared with standard of care, demonstrating its practical application.
RESULTS: The DCEA health value metric indicates that digital therapeutic is more equitable, favoring socioeconomically disadvantaged groups, while standard of care exacerbates health inequality by benefiting the already advantaged. Additionally, digital therapeutic shows potential for boosting productivity, raising income, and creating jobs, supporting its consideration by employer-sponsored health plans to optimize resource allocation for treating OUD.
CONCLUSIONS: The conceptual framework provides insights for enhancing HTAs to incorporate the broader economic and societal impacts of healthcare interventions. By integrating DCEA, extended HTA analysis with input-output modeling, and a voting scheme, decision makers can make informed choices aligned with societal priorities, although further research and validation are necessary for practical implementation across diverse healthcare contexts.
METHODS: We propose a novel conceptual framework, highlighting its three components (distributional cost-effectiveness analysis [DCEA], input-output model, and voting scheme) and their contributions to capturing the economic and societal ripple effects of healthcare interventions. This manuscript also outlines a case study in which the framework is applied to the reassessment of a previously evaluated digital health therapeutic for the treatment of opioid use disorder (OUD) compared with standard of care, demonstrating its practical application.
RESULTS: The DCEA health value metric indicates that digital therapeutic is more equitable, favoring socioeconomically disadvantaged groups, while standard of care exacerbates health inequality by benefiting the already advantaged. Additionally, digital therapeutic shows potential for boosting productivity, raising income, and creating jobs, supporting its consideration by employer-sponsored health plans to optimize resource allocation for treating OUD.
CONCLUSIONS: The conceptual framework provides insights for enhancing HTAs to incorporate the broader economic and societal impacts of healthcare interventions. By integrating DCEA, extended HTA analysis with input-output modeling, and a voting scheme, decision makers can make informed choices aligned with societal priorities, although further research and validation are necessary for practical implementation across diverse healthcare contexts.
摘要：
背景：评估医疗干预措施对健康结果以外的影响可能会导致对人力资本变化的认识，收入水平,税收收入,和政府支出，这可能会影响经济增长和人口健康。在本文中,我们记录了当前卫生技术评估（HTA）实践未能解释医疗干预对医疗保健行业以外的更广泛社会的影响的情况。
方法：我们提出了一个新的概念框架，强调其三个组成部分(分配成本效益分析[DCEA]，投入产出模型，和投票计划)及其对捕捉医疗保健干预的经济和社会连锁反应的贡献。该手稿还概述了一个案例研究，其中该框架被应用于重新评估先前评估的数字健康疗法，以治疗阿片类药物使用障碍（OUD）与标准护理相比，展示其实际应用。
结果：DCEA健康价值指标表明数字治疗更公平，有利于社会经济弱势群体，而护理标准通过使已经处于优势地位的人受益，加剧了健康不平等。此外,数字治疗显示出提高生产力的潜力，提高收入,创造就业机会，通过雇主赞助的健康计划支持其考虑，以优化治疗OUD的资源分配。
结论：概念框架为增强HTAs提供了见解，以纳入医疗保健干预措施的更广泛的经济和社会影响。通过整合DCEA,具有输入输出建模的扩展HTA分析，和投票计划，决策者可以根据社会优先事项做出明智的选择，尽管进一步的研究和验证对于跨不同医疗保健环境的实际实施是必要的.
方法：我们提出了一个新的概念框架，强调其三个组成部分(分配成本效益分析[DCEA]，投入产出模型，和投票计划)及其对捕捉医疗保健干预的经济和社会连锁反应的贡献。该手稿还概述了一个案例研究，其中该框架被应用于重新评估先前评估的数字健康疗法，以治疗阿片类药物使用障碍（OUD）与标准护理相比，展示其实际应用。
结果：DCEA健康价值指标表明数字治疗更公平，有利于社会经济弱势群体，而护理标准通过使已经处于优势地位的人受益，加剧了健康不平等。此外,数字治疗显示出提高生产力的潜力，提高收入,创造就业机会，通过雇主赞助的健康计划支持其考虑，以优化治疗OUD的资源分配。
结论：概念框架为增强HTAs提供了见解，以纳入医疗保健干预措施的更广泛的经济和社会影响。通过整合DCEA,具有输入输出建模的扩展HTA分析，和投票计划，决策者可以根据社会优先事项做出明智的选择，尽管进一步的研究和验证对于跨不同医疗保健环境的实际实施是必要的.
