Access to anticancer medicines in public hospitals of Northwestern China.

Objective: We aimed to evaluate the accessibility of anticancer medicines in public hospitals of Shaanxi, a representative province of Northwestern China. Methods: Thirty-one anticancer medicines were investigated in 146 designated public hospitals in 10 cities of Shaanxi Province. We used medicine procurement data from the Shaanxi Drug Centralized Purchasing Platform during 2019-2021. Primary outcomes included the availability, drug utilization, and affordability of anticancer medicines. Results: The mean availability of 31 anticancer medicines increased significantly from 5.45% in 2019 to 14.72% in 2021. The mean availability of nationally negotiated medicines was significantly lower than that of Class B medicines (8.72% vs. 12.85%, p = 0.048), whilst the availability of injectable medicines was significantly greater than that of oral medicines (13.66% vs. 8.77%, p = 0.007). In 2019-2021, the annual mean amount purchased increased significantly from CNY 6.51 million to CNY 18.56 million (p = 0.007). The mean defined daily doses of 31 medicines significantly rose from 225.50 to 1019.50 (p = 0.008) whereas their defined daily drug cost significantly decreased from CNY 551.15 to CNY 404.50 (p < 0.001). The percentage of catastrophic health expenditure decreased from 71.0 to 51.65% and from 90.30 to 80.60% for urban and rural residents, respectively. The affordability of nationally negotiated medicines was significantly lower than that of Class B medicines (p = 0.032), and the affordability of injectable medicines had no significant difference compared to that of oral medicines (p = 0.124) for both urban and rural residents. Conclusion: The accessibility of anticancer medicines improved dramatically in public hospitals of Northwestern China during the period 2019-2021.

Cost-Effectiveness of Recombinant Zoster Vaccine for Adults Aged ≥50 Years in China.

INTRODUCTION: Adjuvanted recombinant zoster vaccine (RZV) was the first vaccine made available for herpes zoster in China. Authors aimed to evaluate its economic and health impacts on Chinese adults aged ≥50 years. METHODS: A lifetime Markov model was developed to compare the cost-effectiveness of RZV with that of no vaccination from a societal perspective. Model inputs were derived from published literature and analyzed in 2022. Outcomes included total costs, quality-adjusted life-years, incremental cost-effectiveness ratio, and number of herpes zoster and herpes zoster-related cases. Sensitivity analyses were performed to examine the robustness of the model results. RESULTS: RZV was more costly than no vaccination by $2.78 billion with an additional 65,008 quality-adjusted life-years gained and could avoid 1,893,530 herpes zoster cases, 295,761 postherpetic neuralgia cases, 51,734 other complications, and 229 herpes zoster-related deaths. Incremental cost-effectiveness ratios of RZV varied in a range of $34,465.5-$51,002.7 per quality-adjusted life-year. RZV for the entire cohort would be cost-effective when discount rate was <2.4%, a waning rate of 2-dose RZV efficacy decreased to <0.8%, the utility of postherpetic neuralgia was <0.496, duration of postherpetic neuralgia was >12.86 months, or the cost of RZV per dose decreased to <$229.6. In a probabilistic sensitivity analysis, the probability of RZV being cost-effective was 43.95%, 59.32%, 45.27%, and 39.50% for people aged 50-59, 60-69, 70-79, and ≥80 years, respectively, with threefold gross domestic product per capita (37,654.5 per quality-adjusted life-year) as the willingness-to-pay threshold. CONCLUSIONS: RZV was most likely to be cost-effective in people aged 60-69 years. A slight decrease in vaccine cost would result in RZV being cost-effective in all people aged ≥50 years.

Impact of video-led educational intervention on uptake of influenza vaccine among the elderly in western China: a community-based randomized controlled trial.

BACKGROUND: Influenza vaccination coverage rate among the elderly is low in China. We aimed to evaluate the impact of video-led educational intervention on influenza vaccine uptake among the Chinese elderly. METHODS: A randomized controlled trial was conducted in 8 communities of Xi'an, a representative city in western China. Elderly aged over 60 years were randomized to the control group and intervention group (12-minute video education on influenza and its vaccination). Participants' knowledge, attitudes, and practices (KAP) of influenza was assessed by using a questionnaire survey before and after the intervention. The primary outcomes were participants' willingness to get influenza vaccinated and their actual uptake rates in the 2020-21 flu season. Secondary outcomes were the variations of pre- and post-intervention KAP scores. Intention-to-treat analysis was performed to analyze the data, and sensitivity analyses were conducted to examine the robustness of the results. RESULTS: A total of 350 people were enrolled, with 175 individuals for each group. Participants in the intervention group were more willing to receive influenza vaccination than those in the control group (64.6% vs. 51.4%, p<0.05). The influenza vaccination uptake rate occurred in 10.3% of participants in the intervention group and 3.4% in the control group (odds ratio, 3.23; 95% CI 1.25-8.32, p<0.001). The post-intervention KAP scores in the intervention group were significantly higher compared to those in the control group (p<0.001). CONCLUSION: Video-led education was an effective and feasible approach to improve old people's willingness and uptake of influenza vaccination in western China.

Parental Preferences of Influenza Vaccination for Children in China: A National Survey with a Discrete Choice Experiment.

The influenza vaccination coverage among children is low in China. We aimed to conduct a nationwide survey to quantify parental preferences and willingness to pay (WTP) for influenza vaccination for their children. Parents with children aged six months to 18 years from six provinces in China were investigated by a discrete choice experiment regarding six influenza vaccination attributes. Mixed logit models were used to estimate the relative importance of vaccine attributes and parents' WTP. Interaction analysis and subgroup analysis were conducted to explore preference heterogeneity. A total of 1206 parents were included in the analysis. Parents reported vaccine effectiveness as the most important vaccine attribute. The mode of vaccine administration had no significant impact on parents' preferences. Parents aged over 30 years with higher education or income levels were more likely to prefer no influenza vaccination for their children. The largest marginal WTP (CNY 802.57) for vaccination and the largest increase in vaccine uptake (41.85%) occurred with improved vaccine effectiveness from 30% to 80%. Parents from central regions or mid-latitude areas had a relatively lower WTP than those from other regions. No significant difference in the relative importance of vaccine attributes were observed among parents from various regions of China.

Preference of influenza vaccination among the elderly population in Shaanxi province, China.

The influenza vaccination uptake rate is low in China. In the current study, we aimed to explore the preferences of influenza vaccination among the Chinese elderly. A discrete choice experiment design was performed to assess their preferences toward five influenza vaccination attributes, including vaccine effectiveness, duration of protection, severe adverse effects, vaccination cost, and vaccination recommendation source. A total of 144 participants aged over 60 years from three cities of Shaanxi province in China were surveyed. A mixed logit model was employed to analyze the data. The elderly population were found to prefer influenza vaccination with a longer duration of protection, followed by lower severe adverse effects, higher vaccine effectiveness, and recommended by healthcare providers. The vaccination cost was the least important attribute. The most considerable marginal willingness to pay for vaccination (CNY220.90) and the highest vaccination choice probability (83.70%) occurred when the duration of protection extended from 3 to 12 months. The present study's findings would inform decision-makers on implementing appropriate interventions for the increase of influenza vaccination coverage among the elderly in China.