In vitro fertilisation (IVF) is a key treatment for infertility, but uptake and continuation may be limited by treatment burden, side effects and out-of-pocket costs. Evidence on IVF treatment preferences among women in China remains limited. This study examined the preferences of Chinese women experiencing infertility for different IVF treatment attributes. A discrete choice experiment was conducted using face-to-face surveys to elicit preferences among women experiencing infertility receiving IVF treatment. Five attributes were examined: number of visits per cycle, side effects, treatment costs per cycle, information disclosure about IVF and pregnancy rate per cycle. Preference weights were estimated using the mixed logit model. Willingness to pay and relative importance of the attributes were estimated. Scenario and heterogeneity analyses were performed. 591 participants were included in the final analysis. All five attributes significantly influenced preferences. Pregnancy rate per cycle was the most important attribute, followed by side effects, treatment costs, information disclosure and number of visits. Increasing the pregnancy rate from 15% to 60% per cycle produced the largest utility gain. Participants were willing to pay ¥56 099.89 for this improvement, ¥22 718.73 to reduce side effects from serious to mild, ¥8720.87 for always receiving information versus none and ¥6429.00 to reduce visits from 30 to 10 per cycle. Preference heterogeneity was associated with education and household income. Chinese women undergoing infertility treatment place the greatest value on higher IVF pregnancy rates, fewer side effects and lower treatment costs. Patient-centred counselling, burden-reduction strategies and policies that reduce financial barriers, including potential insurance coverage, may improve IVF acceptability, continuation and utilisation. Tailored approaches are needed to address preference heterogeneity across patient subgroups.
@article{lu2026infertility,author={Lu, Liyong and Shi, Zhao and Jiang, Shan and Wang, Haipeng and Li, Shunping},title={Preferences of Women Experiencing Infertility for In Vitro Fertilisation Treatment in China: A Discrete Choice Experiment},journal={BMJ Public Health},volume={4},number={2},pages={e002188},year={2026},doi={10.1136/bmjph-2024-002188},}
Is Best-Worst Scaling Suitable for Patient Preference Elicitation? A Nationwide Representative Comparison with Discrete Choice Experiments among Patients with Type 2 Diabetes in China
Shimeng Liu, Yingyao Chen, Ying Tao, and 4 more authors
Incorporating patient perspectives is essential in health technology assessments. Selecting appropriate tools, such as discrete choice experiment (DCE) or best-worst scaling (BWS), is critical for generating high-quality evidence. This study aims to compare preference estimates and response consistency between DCE and BWS profile case (BWS-2) and provide empirical guidance on the optimal method for patient preference elicitation. Multistage stratified cluster sampling was used to recruit 3327 patients with type 2 diabetes mellitus (T2DM) from 50 health institutions for face-to-face interviews conducted from September to December 2022. Participants completed DCE and BWS-2 tasks involving hypothetical antihyperglycaemic medication profiles defined by seven attributes: efficacy, hypoglycaemia risk, cardiovascular benefits, gastrointestinal adverse events, weight change, mode of administration and out-of-pocket cost. Each participant completed six DCE and six BWS-2 tasks in randomised order (DCE first followed by BWS, or BWS first followed by DCE). Responses were analysed using mixed logit and generalised multinomial logit models. Method concordance was assessed with Spearman’s correlation, and response consistency was evaluated through scale heterogeneity. Preference weights from DCE and BWS-2 showed moderate concordance (Spearman’s r>0.70). DCE exhibited greater scale heterogeneity (τ=0.931, p<0.01) than BWS-2(τ=0.450, p<0.01), indicating more variable responses in DCE. Highly educated respondents exhibited similar levels of choice consistency (τ=0.478, and 0.467 in DCE and BWS-2, p<0.01, respectively) regardless of the preference elicitation tool used. However, respondents with lower education levels or illiteracy displayed higher choice consistency in BWS-2. While DCE and BWS-2 produced comparable preference estimates, the higher consistency in BWS-2 responses suggests it may be more reliable for eliciting patient medication preferences, especially those lower educated or illiteracy patients.
@article{liu2026bws,author={Liu, Shimeng and Chen, Yingyao and Tao, Ying and Lian, Dai and Jiang, Shan and Li, Shunping and Gu, Yuan-Yuan},title={Is Best-Worst Scaling Suitable for Patient Preference Elicitation? A Nationwide Representative Comparison with Discrete Choice Experiments among Patients with Type 2 Diabetes in China},journal={BMJ Public Health},volume={4},number={1},pages={e003571},year={2026},doi={10.1136/bmjph-2025-003571},}
Productivity-adjusted life year loss among the late middle-aged adults in China
Yawen Jiang, Bingxin Hu, Huiqiao Gu, and 4 more authors
@article{jiang2026paly,author={Jiang, Yawen and Hu, Bingxin and Gu, Huiqiao and Hu, Wenjie and Jiang, Shan and Gu, Yuanyuan and Si, Lei},title={Productivity-adjusted life year loss among the late middle-aged adults in China},journal={Communications Medicine},volume={6},number={1},pages={34},year={2026},doi={10.1038/s43856-025-01294-8},}
Treatment Preferences in Type 2 and Type 3 Spinal Muscular Atrophy Adult Patients: Evidence from a Discrete Choice Experiment in China
Jiaqi Yuan, Shunping Li, Lei Dou, and 3 more authors
The Patient — Patient-Centred Outcomes Research. IF = 3.6 , 2026
@article{yuan2026sma,author={Yuan, Jiaqi and Li, Shunping and Dou, Lei and Xing, Huanping and Lu, Liyong and Jiang, Shan},title={Treatment Preferences in Type 2 and Type 3 Spinal Muscular Atrophy Adult Patients: Evidence from a Discrete Choice Experiment in China},journal={The Patient — Patient-Centred Outcomes Research},year={2026},doi={10.1007/s40271-026-00818-1},}
Public Perceptions of Genetic Sequencing in China: Barriers and Drivers of Adoption
Liyong Lu, Shan Jiang, Yuan Wang, and 3 more authors
European Journal of Human Genetics. IF = 5.1 , 2026
This study explores public attitudes toward genetic sequencing (GS) services in China and identifies key factors influencing adoption. Although GS has the potential to strengthen precision public health, its uptake may be constrained by societal and attitudinal barriers. We used a sequential mixed-methods design, combining focus group discussions with a structured ranking questionnaire. A total of 28 participants (mean age 48.9 years) were included. The qualitative analysis identified five major themes reflecting participants’ understanding, concerns, and expectations regarding GS. Quantitatively, the most influential factors for adoption were the characteristics of genomic information and financial accessibility. Demographic differences were observed: men prioritized cost, whereas women emphasized clarity of information; older adults focused on affordability, whereas younger participants valued transparency and the utility of information. Psychological concerns also emerged as an important barrier, including fears of genetic discrimination and emotional distress arising from the implications of genetic information. In contrast to European studies that often highlight privacy and data protection, participants in this study placed greater emphasis on informational and financial considerations. Despite the modest sample, thematic saturation was reached and the mixed-methods approach provides complementary qualitative and quantitative evidence. Addressing public concerns through transparent communication, education, psychological support, and affordability-focused policies will be important to facilitate integration of GS into healthcare systems. These findings provide culturally grounded evidence to inform precision public health in China and similar contexts.
@article{lu2026genetic,author={Lu, Liyong and Jiang, Shan and Wang, Yuan and Liu, Sidong and Lu, Jiao and Gu, Yuanyuan},title={Public Perceptions of Genetic Sequencing in China: Barriers and Drivers of Adoption},journal={European Journal of Human Genetics},volume={34},number={6},pages={852--860},year={2026},doi={10.1038/s41431-026-02109-7},}
Strengthening Methods and International Evidence on Health Inequality Aversion
Marie-Anne Boujaoude, Nancy Devlin, Tim Doran, and 9 more authors
@article{boujaoude2026aversion,author={Boujaoude, Marie-Anne and Devlin, Nancy and Doran, Tim and Hurley, Jeremiah and Cookson, Richard and Ali, Shehzad and Asada, Yukiko and Barra, Mathias and He, Xiaoning and Horn, Sindre and Jiang, Shan and others},title={Strengthening Methods and International Evidence on Health Inequality Aversion},journal={Value in Health},volume={29},number={6},pages={981--985},year={2026},doi={10.1016/j.jval.2025.11.006},}
2025
Evaluating Cost Effectiveness and Distributional Impact of Breast Cancer Screening: A Distributional Cost-Effectiveness Analysis Incorporating Patient Preference
Shan Jiang, Bonny Parkinson, and Yuanyuan Gu
International Journal of Technology Assessment in Health Care (Abstract), 2025
Hereditary breast and ovarian cancer, linked to BRCA gene mutations, poses significant health risks. Australian breast and ovarian cancer mortality rates emphasize the public health importance of effective screening. This study evaluated the cost effectiveness of population-wide BRCA screening and its equity implications, focusing on reducing health disparities across socioeconomic groups through early detection and prevention strategies. A cost-effectiveness analysis was conducted comparing population-wide BRCA screening to family-history-based testing for Australian women aged 30 to 50 years. A decision-analytic model included a decision tree and two Markov models simulating outcomes over a lifetime horizon. Transition probabilities captured risk-reducing interventions. Outcomes included quality-adjusted life years (QALYs) and costs in 2024 AUD, discounted at five percent. Socioeconomic quintiles were defined using Socio-Economic Indexes for Areas, and distributional impacts were assessed with net health benefits and equally distributed equivalent health (EDEH) using the Atkinson index. Model inputs were derived from census data and empirical studies. Opportunity costs used UK data as a proxy. Screening at the age of 30 years was cost saving (incremental cost-effectiveness ratio [ICER] −AUD8,331 [−USD5,482] per QALY), while screening at ages 35 and 40 years was cost effective (ICERs: AUD28,231 [USD18,577] and AUD40,086 [USD26,384] per QALY, respectively). Screening at ages 45 and 50 years exceeded the threshold (ICERs: AUD78,666 [USD51,778] and AUD155,937 [USD102,640] per QALY). Distributional analysis showed screening at the age of 30 years increased average quality-adjusted life expectancy and EDEH, reducing health inequality between socioeconomic groups. In contrast, screening at older ages resulted in diminished benefits and exacerbated inequalities, highlighting the importance of early intervention in achieving both cost-effectiveness and equity goals. Population-wide BRCA screening was cost effective for Australian women at younger ages, particularly at the age of 30 years, and reduced health inequalities. Policymakers should prioritize early screening to address hereditary breast and ovarian cancer, promote health equity, and alleviate disease burden. Further strategies to enhance access among disadvantaged groups could amplify these benefits, advancing a more equitable healthcare system.
@article{jiang2025ijtahc,author={Jiang, Shan and Parkinson, Bonny and Gu, Yuanyuan},title={Evaluating Cost Effectiveness and Distributional Impact of Breast Cancer Screening: A Distributional Cost-Effectiveness Analysis Incorporating Patient Preference},journal={International Journal of Technology Assessment in Health Care (Abstract)},volume={41},number={S1},pages={S13--S14},year={2025},doi={10.1017/S026646232510086X},}
Shall We Pay More For Rare Disease Drugs? Assessing Decision-Makers’ Preferences Using A Sequential Discrete Choice Experiment Approach
Yuanyuan Gu, Shan Jiang, Shunping Li, and 1 more author
International Journal of Technology Assessment in Health Care (Abstract), 2025
Globally, knee osteoarthritis (OA) is a prevalent and disabling condition. Intra-articular glucocorticoid injection (IAGI) is widely used to treat knee OA. However, there is conflicting evidence on the benefit-harm profile of IAGI for this indication. This study aimed to determine the clinical effectiveness and safety of IAGI for knee OA. Systematic literature searches were conducted in three biomedical databases (MEDLINE, Embase, the Cochrane Library) through to 4 October 2023. Randomized controlled trials (RCTs) that compared IAGI with no treatment, sham injection, or oral placebo in patients with knee OA were included. RCTs were appraised using the revised Cochrane risk-of-bias tool. Longitudinal meta-analysis (LMA) was conducted for predetermined outcomes (i.e., pain, function, health-related quality of life [HRQoL], care utilization, adverse events [AEs], and serious adverse events) at one month, three months, six months, and 12 months. Pairwise meta-analyses were conducted at individual time points if there was insufficient evidence to conduct a LMA. The research project was funded by the Swiss Federal Office of Public Health. In total, 16 RCTs comprising 1,522 patients with knee OA were included. The LMA reported a small reduction in pain at one month (standardized mean difference: −0.30, 95% confidence interval [CI]: −0.52, −0.08), but no clinically or statistically significant differences from three to 12 months. Regarding function, the LMA found no significant differences at any time point. Pairwise meta-analyses at one month showed reduced care utilization favoring IAGI (mean difference −0.43; 95% CI: −0.81, −0.05), but not at other time points, and no differences in HRQoL at any time point. No significant safety concerns were found in relation to AEs and serious AEs. IAGI provided short-term pain relief for knee OA at one month post-injection, with beneficial effects diminishing by three months and beyond. There were no substantial improvements in function or HRQoL. No significant safety concerns were identified. To guide clinical decision-making, further research should focus on HRQoL as well as potential subgroups of patients that may benefit in the longer term.
@article{gu2025raredrugs,author={Gu, Yuanyuan and Jiang, Shan and Li, Shunping and Wang, Haiyin},title={Shall We Pay More For Rare Disease Drugs? Assessing Decision-Makers' Preferences Using A Sequential Discrete Choice Experiment Approach},journal={International Journal of Technology Assessment in Health Care (Abstract)},volume={41},number={S1},pages={S9},year={2025},doi={10.1017/S0266462325100779},}
What Do Chinese Patients Value in Orthodontic Treatment? A Discrete Choice Experiment
Lidan Wang, Dandan Yu, Shan Jiang, and 7 more authors
@article{wang2025orthodontic,author={Wang, Lidan and Yu, Dandan and Jiang, Shan and Li, Yihui and Yao, Wang and Liu, Jiajia and Cheng, Han and Xu, Jianguang and Xu, Wenhua and Gu, Yuanyuan},title={What Do Chinese Patients Value in Orthodontic Treatment? A Discrete Choice Experiment},journal={BMC Oral Health},year={2025},note={Forthcoming},}
How Policymakers Value End-of-Life Treatments for Rare and Common Diseases in China: Evidence from a Contingent Valuation Study
Han Cheng, Shan Jiang, Taoran Liu, and 6 more authors
Global Health Research and Policy. IF = 4.6 , 2025
Understanding policymakers’ value judgements in reimbursement decisions is essential for promoting equity and guiding informed healthcare decision-making. This study aimed to estimate and compare Chinese policymakers’ willingness-to-pay (WTP) per quality-adjusted life year (QALY) specifically in end-of-life treatment scenarios involving life-threatening common and rare diseases. We conducted a contingent valuation study employing single-bounded dichotomous-choice questions among 120 experts formally appointed by China’s National Healthcare Security Administration to serve on the National Reimbursement Drug List Expert Committee in recent years. Participants evaluated hypothetical scenarios describing end-of-life treatments providing a one-QALY gain for patients with life-threatening common or rare diseases. Data were collected primarily through face-to-face interviews, supplemented by online responses when in-person meetings were impractical. Statistical analysis was performed using probit regression models, and t-tests were conducted to compare WTP values between scenarios. A total of 99 policymakers participated. Participants’ WTP per QALY for end-of-life treatments in common disease scenarios ranged from CNY 78,031 (0.98 times GDP per capita) to CNY 126,449 (1.58 times GDP per capita). In contrast, WTP was significantly higher for rare diseases, ranging from CNY 183,392 (2.29 times GDP per capita) to CNY 219,691 (2.75 times GDP per capita). Analysis of individual characteristics revealed that female participants and those with expertise in pharmacoeconomics exhibited significantly higher WTP values in common disease scenarios ( p < 0.05), though these factors had varied effects in rare disease scenarios. This study provides novel estimates of Chinese policymakers’ WTP per QALY specifically in end-of-life contexts involving common and rare diseases, highlighting the significant impact of disease rarity on reimbursement decisions. These findings offer empirical support for adopting differentiated cost-effectiveness thresholds tailored to end-of-life treatments based on disease rarity in China.
@article{cheng2025endoflife,author={Cheng, Han and Jiang, Shan and Liu, Taoran and Li, Boyang and Chen, Shanquan and Li, Ao and Chen, Hao and Wang, Haiyin and Gu, Yuanyuan},title={How Policymakers Value End-of-Life Treatments for Rare and Common Diseases in China: Evidence from a Contingent Valuation Study},journal={Global Health Research and Policy},year={2025},doi={10.1186/s41256-025-00434-w},}
Genomic sequencing technologies for rare disease in mainstream medicine: the current state of implementation
Michael Mackley, Pankaj Agrawal, Sara Ali, and 8 more authors
European Journal of Human Genetics. IF = 5.1. Invited by the journal Chief-Editor to co-author with world-leading experts in the field , 2025
@article{mackley2025genomic,author={Mackley, Michael and Agrawal, Pankaj and Ali, Sara and Archibald, Alison and Dawson-McClaren, Belinda and Ellard, Holly and Freeman, Lucinda and Gu, Yuanyuan and Jayasinghe, Kushani and Jiang, Shan and others},title={Genomic sequencing technologies for rare disease in mainstream medicine: the current state of implementation},journal={European Journal of Human Genetics},volume={33},pages={1402--1413},year={2025},doi={10.1038/s41431-025-01925-7},}
Aggregate Distributional Cost-Effectiveness Analysis: A Novel Tool for Health Economic Evaluation to Inform Resource Allocation
Shan Jiang, Boyang Li, Bonny Parkinson, and 2 more authors
Global Health Research and Policy. IF = 4.6 , 2025
Health equity is a growing concern for policymakers across the globe. Conventional cost-effectiveness analysis (CEA), commonly used in evaluating health interventions, primarily focuses on the average and aggregate health outcomes in the targeted population, neglecting the distributional impacts on health equity. This gap calls for approaches that can quantify the impact of intervention of interest on health equity to support decision-making. Distributional Cost-Effectiveness Analysis (DCEA) offers a framework to assess the distributional impacts of health interventions. Based on DCEA, aggregate DCEA (A-DCEA) was proposed as a practical and simplified alternative to DCEA. Unlike full DCEA, which requires detailed subgroup data, A-DCEA utilizes aggregated data, making it accessible and feasible for broader use. In this commentary, we discuss the rationale for A-DCEA, outline the steps for its implementation, and highlight its applicability. The purpose of this article is to introduce A-DCEA as a pragmatic and accessible tool for evaluating the equity implications of healthcare interventions. A-DCEA can inform policymakers by incorporating equity considerations into healthcare decision-making, particularly when conducting a full DCEA is impractical due to data limitation. A-DCEA provides a valuable and accessible method for evaluating the distributional impact of interventions, promoting health equity in decision-making. Its adoption can lead to more informed health policy that considers health inequities as well as the efficient use of resources.
@article{jiang2025adcea,author={Jiang, Shan and Li, Boyang and Parkinson, Bonny and Li, Shunping and Gu, Yuanyuan},title={Aggregate Distributional Cost-Effectiveness Analysis: A Novel Tool for Health Economic Evaluation to Inform Resource Allocation},journal={Global Health Research and Policy},year={2025},doi={10.1186/s41256-025-00415-z},}
Cost-effectiveness of toripalimab plus chemotherapy versus chemotherapy as first-line treatment for advanced non-small cell lung cancer in China: a societal perspective
Dai Lian, Yi Yang, Yuling Gan, and 5 more authors
Expert Review of Pharmacoeconomics & Outcomes Research. IF = 2.8 , 2025
@article{lian2025toripalimab,author={Lian, Dai and Yang, Yi and Gan, Yuling and Xiao, Dunming and Xiang, Yuliang and Jiang, Shan and Gu, Yuanyuan and Chen, Yingyao},title={Cost-effectiveness of toripalimab plus chemotherapy versus chemotherapy as first-line treatment for advanced non-small cell lung cancer in China: a societal perspective},journal={Expert Review of Pharmacoeconomics \& Outcomes Research},year={2025},doi={10.1080/14737167.2025.2451748},}
Physicians’ risk and time preferences and their willingness to detect and disclose genomic secondary findings: A multiple price list experiment
Shan Jiang, Haiyin Wang, Zhuo Chen, and 4 more authors
@article{jiang2025physicians,author={Jiang, Shan and Wang, Haiyin and Chen, Zhuo and Zang, Xiao and Jiang, Yawen and Zhou, Zhongliang and Gu, Yuanyuan},title={Physicians' risk and time preferences and their willingness to detect and disclose genomic secondary findings: A multiple price list experiment},journal={Pharmacoeconomics and Policy},year={2025},doi={10.1016/j.pharp.2025.02.001},}
2024
Secondary Risk-Reducing Strategies for Contralateral Breast Cancer in BRCA1/2 Variant Carriers: A Systematic Review and Meta-analysis
Jing Yu, Shan Jiang, Taoran Liu, and 7 more authors
@article{yu2024brca,author={Yu, Jing and Jiang, Shan and Liu, Taoran and Gao, Yangyang and Ma, Xinyang and Fekadu, Ginenus and Xia, Yunqiu and Parkinson, Bonny and Ming, Wai-kit and Gu, Yuanyuan},title={Secondary Risk-Reducing Strategies for Contralateral Breast Cancer in BRCA1/2 Variant Carriers: A Systematic Review and Meta-analysis},journal={Advances in Therapy},year={2024},doi={10.1007/s12325-024-02808-x},}
Synthesized economic evidence on the cost-effectiveness of screening familial hypercholesterolemia
Mengying Wang, Shan Jiang, Boyang Li, and 5 more authors
Global Health Research and Policy. IF = 5.0 , 2024
Familial hypercholesterolemia (FH) is a prevalent genetic disorder with global implications for severe cardiovascular diseases. Motivated by the growing recognition of the need for early diagnosis and treatment of FH to mitigate its severe consequences, alongside the gaps in understanding the economic implications and equity impacts of FH screening, this study aims to synthesize the economic evidence on the cost-effectiveness of FH screening and to analyze the impact of FH screening on health inequality. We conducted a systematic review on the economic evaluations of FH screening and extracted information from the included studies using a pre-determined form for evidence synthesis. We synthesized the cost-effectiveness components involving the calculation of synthesized incremental cost-effectiveness ratios (ICERs) and net health benefit (NHB) of different FH screening strategies. Additionally, we applied an aggregate distributional cost-effectiveness analysis (DCEA) to assess the impact of FH screening on health inequality. Among the 19 studies included, over half utilized Markov models, and 84% concluded that FH screening was potentially cost-effective. Based on the synthesized evidence, cascade screening was likely to be cost-effective, with an ICER of 49,630 per quality-adjusted life year (QALY). The ICER for universal screening was 20,860 per QALY as per evidence synthesis. The aggregate DCEA for six eligible studies presented that the incremental equally distributed equivalent health (EDEH) exceeded the NHB. The difference between EDEH and NHB across the six studies were 325, 137, 556, 36, 50, and 31 QALYs, respectively, with an average positive difference of 189 QALYs. Our research offered valuable insights into the economic evaluations of FH screening strategies, highlighting significant heterogeneity in methods and outcomes across different contexts. Most studies indicated that FH screening is cost-effective and contributes to improving overall population health while potentially reducing health inequality. These findings offer implications that policies should promote the implementation of FH screening programs, particularly among younger population. Optimizing screening strategies based on economic evidence can help identify the most effective measures for improving health outcomes and maximizing cost-effectiveness.
@article{wang2024fh,author={Wang, Mengying and Jiang, Shan and Li, Boyang and Parkinson, Bonny and Lu, Jiao and Tan, Kai and Gu, Yuanyuan and Li, Shunping},title={Synthesized economic evidence on the cost-effectiveness of screening familial hypercholesterolemia},journal={Global Health Research and Policy},volume={9},number={1},pages={38},year={2024},doi={10.1186/s41256-024-00382-x},}
Economic evaluation of newborn deafness gene screening as a public health intervention in China: a modelling study
Jun-Tao Shu, Yuan-Yuan Gu, Pei-Yao Zhai, and 11 more authors
While global newborn hearing screening programmes (NHSP) are far from the optimal level, the combined hearing and genetic screening has emerged as an innovative approach of early healthcare interventions. There is a clear need for economic evaluation to establish whether newborn deafness gene screening (NDGS), currently mandated by many cities in China, is a good investment. A decision-tree model was constructed to simulate a hypothetical 10-million Chinese newborn cohort over a lifetime with three strategies: (1) no screening, (2) NHSP (standard screening) and (3) NHSP+NDGS (combined screening). The presence of permanent congenital hearing loss (PCHL) and genetic mutation were assigned at birth and held constant for all strategies. Input parameters were obtained from the Cohort of Deafness-gene Screening study and literature review. The government contract price for genetic screening was US77/child. Outcomes of interest included the number of early diagnosed PCHL, prelingual deafness, total deafness, special education referral, incremental cost-effectiveness ratio (ICER) and benefit–cost ratio (BCR). Both standard and combined screening strategies were more effective and more costly than ‘no screening’. Compared with standard screening, combined screening led to 9112 (28.0%) more PCHL cases early detected, avoiding 4071 (66.9%) prelingual deafness cases and 3977 (15.6%) special education referrals. The ICER and BCR for combined screening were US 4995/disability-adjusted life-year (95% uncertainty interval, 2963 to 9265) and 1.78 (1.19 to 2.39), from healthcare sector perspective. Combined screening would dominate standard screening from societal perspective. Moreover, it remained cost-effective even in pessimistic scenarios. Our findings have particular implication for the ‘scale-up’ of genetic screening at the national level in China. The model may serve as a feasible example for hearing screening strategies in other countries, as well as genetic screening for other diseases.
@article{shu2024deafness,author={Shu, Jun-Tao and Gu, Yuan-Yuan and Zhai, Pei-Yao and Wen, Cheng and Qian, Min and Wu, You-Jia and Zhuang, Xun and Zhu, Qing-Wen and Zhang, Lu-Ping and Jiang, Shan and Wang, Xiao-Mo and Jiang, Yin-Hua and Huang, Li-Hui and Qin, Gang},title={Economic evaluation of newborn deafness gene screening as a public health intervention in China: a modelling study},journal={BMJ Public Health},year={2024},doi={10.1136/bmjph-2023-000838},}
Cost-Effectiveness Analysis of Sintilimab Plus Chemotherapy in Advanced Non-Squamous Non-Small Cell Lung Cancer: A Societal Perspective
Fuming Li, Yingyao Chen, Dunming Xiao, and 2 more authors
@article{li2024sintilimab,author={Li, Fuming and Chen, Yingyao and Xiao, Dunming and Jiang, Shan and Yang, Yi},title={Cost-Effectiveness Analysis of Sintilimab Plus Chemotherapy in Advanced Non-Squamous Non-Small Cell Lung Cancer: A Societal Perspective},journal={Advances in Therapy},year={2024},doi={10.1007/s12325-024-02808-x},}
Enhancing Neonatal Intensive Care With Rapid Genome Sequencing
Shan Jiang, Bonny Parkinson, and Yuanyuan Gu
JAMA Network Open (Invited Commentary). IF = 9.7. Selected among the Best 20 Publications at MUCHE (2021–2025) , 2024
@article{jiang2024jama,author={Jiang, Shan and Parkinson, Bonny and Gu, Yuanyuan},title={Enhancing Neonatal Intensive Care With Rapid Genome Sequencing},journal={JAMA Network Open (Invited Commentary)},year={2024},doi={10.1001/jamanetworkopen.2024.0097},}
Patient Welfare Implications of Indication-specific Value-based Pricing of Multi-indication Drugs
Yawen Jiang, Meng Li, Shan Jiang, and 2 more authors
Value in Health. IF = 6.0. Best Paper of the Year 2024 selected by the journal editorial board — only one worldwide , 2024
@article{jiang2024vbp,author={Jiang, Yawen and Li, Meng and Jiang, Shan and Si, Lei and Gu, Yuanyuan},title={Patient Welfare Implications of Indication-specific Value-based Pricing of Multi-indication Drugs},journal={Value in Health},year={2024},doi={10.1016/j.jval.2023.11.008},}
Authors’ Reply: The Need for a Bleed Type-Specific Annual Bleeding Rate in Hemophilia Studies
Limin Wang, Shimeng Liu, Shan Jiang, and 4 more authors
JMIR Public Health and Surveillance. IF = 3.5 , 2024
@article{wang2024hemophilia,author={Wang, Limin and Liu, Shimeng and Jiang, Shan and Li, Chaofan and Lu, Liyong and Fang, Yunhai and Li, Shunping},title={Authors' Reply: The Need for a Bleed Type-Specific Annual Bleeding Rate in Hemophilia Studies},journal={JMIR Public Health and Surveillance},year={2024},doi={10.2196/54756},}
2023
Prophylactic Interventions for Hereditary Breast and Ovarian Cancer Risks and Mortality in BRCA1/2 Carriers
Taoran Liu, Jing Yu, Yangyang Gao, and 4 more authors
Background: Hereditary breast and ovarian cancers (HBOCs) pose significant health risks worldwide and are mitigated by prophylactic interventions. However, a meta-analysis of their efficacy and the impact of different genetic variants on their effectiveness is lacking. Methods: A systematic review and meta-analysis were conducted, adhering to Cochrane guidelines. The review encompassed studies that involved prophylactic interventions for healthy women with BRCA variants, focusing on cancer incidence and mortality outcomes. The Newcastle–Ottawa Scale was used for risk of bias assessment. We pooled the extracted outcomes using random effects models and conducted subgroup analyses stratified by intervention, variant, and cancer types. Results: A total of 21 studies met the inclusion criteria. The meta-analysis revealed that prophylactic interventions significantly reduced cancer risk and mortality. The subgroup analysis showed a greater protective effect for BRCA2 than BRCA1 variant carriers. Risk-reducing surgeries (RRS) were more effective than chemoprevention, with RRS notably reducing cancer risk by 56% compared to 39% for chemoprevention. Prophylactic oophorectomy significantly reduced HBOC risks, while the effect of prophylactic mastectomy and chemoprevention on mortality was less conclusive. Conclusions: Prophylactic interventions significantly reduce the risk of HBOC and associated mortality. This comprehensive analysis provides insights for future economic evaluations and clinical decision-making in HBOC interventions.
@article{liu2023hboc,author={Liu, Taoran and Yu, Jing and Gao, Yangyang and Ma, Xinyang and Jiang, Shan and Gu, Yuanyuan and Ming, Wai-kit},title={Prophylactic Interventions for Hereditary Breast and Ovarian Cancer Risks and Mortality in BRCA1/2 Carriers},journal={Cancers},year={2023},doi={10.3390/cancers16010103},}
Blood Donors’ Preferences Toward Incentives for Donation in China
Yu Wang, Peicong Zhai, Shan Jiang, and 2 more authors
Blood donation is critical for health care systems, but donor retention remains challenging. Understanding donors’ preferences can inform incentive design and improve retention rates. To identify donor preferences for incentive attributes and their relative importance in promoting blood donation among Chinese donors in Shandong. This survey study fielded a discrete choice experiment (DCE) with a dual response design among blood donors, analyzing the responses under forced and unforced choice settings. The study took place from January 1 to April 30, 2022, in 3 cities (Yantai, Jinan, and Heze) representing diverse socioeconomic strata in Shandong, China. Eligible participants were blood donors aged 18 to 60 years who had donated within the preceding 12 months. Participants were recruited using convenience sampling. Data were analyzed from May to June 2022. Respondents were presented with different blood donation incentive profiles, varying in health examination, blood recipient, honor recognition, travel time, and gift value. Respondent preferences for nonmonetary incentive attributes, attribute relative importance, willingness-to-discard values for attribute improvement, and estimated uptake of new incentive profiles. A total of 650 donors were invited, of which 477 were included for analysis. The respondents were predominately male (308 respondents [64.6%]), aged 18 to 34 years (291 respondents [61.0%]), and had undergraduate degrees or higher (286 respondents [59.9%]). Among the 477 valid respondents, the mean (SD) age was 31.9 (11.2) years. Respondents preferred comprehensive health examination, family members as recipients, central government recognition, 30-minute travel time, and a gift valued at 60 Renminbi (RMB). No significant differences were found between the model results of forced and unforced choice setting. Blood recipient was the most important attribute, followed by health examination and gifts, and then honor and travel time. Respondents were willing to discard RMB 32 (95% CI, 18-46) for an improved health examination and RMB 69 (95% CI, 47-92) for changing the recipient from themselves to family members. Scenario analysis estimated 80.3% (SE, 0.024) of donors would endorse the new incentive profile if the recipient was changed from themselves to family members. In this survey study, blood recipient, health examination, and gift value were perceived more important as nonmonetary incentives than travel time and honor recognition. Tailoring incentives according to these preferences may improve donor retention. Further research could help refine and optimize incentive schemes for blood donation promotion.
@article{wang2023blooddonors,author={Wang, Yu and Zhai, Peicong and Jiang, Shan and Li, Chaofan and Li, Shunping},title={Blood Donors' Preferences Toward Incentives for Donation in China},journal={JAMA Network Open},year={2023},doi={10.1001/jamanetworkopen.2023.18320},}
Gauging Incentive Values and Expectations (G.I.V.E.) study among Blood Donors for Non-monetary Incentives: Developing a Preference Elicitation Instrument through Qualitative Approaches in Shandong, China
Yu Wang, Peicong Zhai, Yue Zhang, and 3 more authors
The Patient — Patient-Centered Outcomes Research. IF = 3.6 , 2023
@article{wang2023give,author={Wang, Yu and Zhai, Peicong and Zhang, Yue and Jiang, Shan and Chen, Gang and Li, Shunping},title={Gauging Incentive Values and Expectations (G.I.V.E.) study among Blood Donors for Non-monetary Incentives: Developing a Preference Elicitation Instrument through Qualitative Approaches in Shandong, China},journal={The Patient — Patient-Centered Outcomes Research},year={2023},doi={10.1007/s40271-023-00639-6},}
Breast Cancer Screening Should Embrace Precision Medicine: Evidence by Reviewing Economic Evaluations in China
Jingjing Jiang, Shan Jiang, Antonio Ahumada-Canale, and 4 more authors
@article{jiang2023bcscreening,author={Jiang, Jingjing and Jiang, Shan and Ahumada-Canale, Antonio and Chen, Zhuo and Si, Lei and Yang, Li and Gu, Yuanyuan},title={Breast Cancer Screening Should Embrace Precision Medicine: Evidence by Reviewing Economic Evaluations in China},journal={Advances in Therapy},year={2023},doi={10.1007/s12325-023-02450-z},}
ICER Threshold Adjustment in China Incorporating Equity Considerations: A Case Study of Orphan Drugs
Shan Jiang, Yuanyuan Gu, Shunping Li, and 1 more author
China Pharmaceutical Circulation Association (Technical Report, Chinese), 2023
@article{jiang2023icer,author={Jiang, Shan and Gu, Yuanyuan and Li, Shunping and Wang, Haiyin},title={ICER Threshold Adjustment in China Incorporating Equity Considerations: A Case Study of Orphan Drugs},journal={China Pharmaceutical Circulation Association (Technical Report, Chinese)},year={2023},}
Preferences for public long-term care insurance among middle-aged and elderly residents: A discrete choice experiment in Hubei Province, China
It is critical to incorporate residents’ preferences into the design of long-term care insurance (LTCI). However, little is known about middle-aged and elderly residents’ preferences for personalized need-related attributes of LTCI in China. Through a discrete choice experiment (DCE), we aimed to focus on the direct beneficiaries of LTCI and then elicit their preferences for LTCI under a hypothetical scenario of dysfunction. Attributes and levels were defined through a literature review and two rounds of expert consultations (n = 8). A D-optimal fractional factorial design was used to generate the DCE questionnaire. Face-to-face interviews with middle-aged and elderly residents were conducted in two cities in Hubei Province, China, between November and December 2020. A mixed logit model was utilized for estimation. Five attributes were identified and incorporated into the DCE questionnaire. A total of 390 participants completed DCE questionnaires. Care facilities, care content, reimbursement rate, caregivers, and annual premium per person all had a significant impact on residents’ preferences. Residents had significantly higher preferences for the LTCI scheme with home and community-based care centers (β = 1.40, p < 0.01), multi-level services (β = 0.44, p < 0.01), 90% reimbursement rate (β = 0.37, p < 0.01), and sufficiently trained caregivers (β = 0.26, p < 0.01). Individual characteristics, such as gender, employment, and education level were the factors that drove heterogeneity in preferences for LTCI. This study provides new evidence on the preferences of middle-aged and elderly residents for personalized need-related public LTCI features. The design of the LTCI scheme in China needs to take these findings into account to maximize the utility for direct beneficiaries of LTCI and enhance their enrollment.
@article{ma2023ltci,author={Ma, He and Jia, Erping and Ma, Huimin and Pan, Yanzhi and Jiang, Shan and Xiong, Juyang},title={Preferences for public long-term care insurance among middle-aged and elderly residents: A discrete choice experiment in Hubei Province, China},journal={Frontiers in Public Health},year={2023},doi={10.3389/fpubh.2023.1050407},}
2022
Cost Effectiveness of Denosumab for Secondary Prevention of Osteoporotic Fractures Among Postmenopausal Women in China: An Individual-Level Simulation Analysis
Yawen Jiang, Shan Jiang, Limin Li, and 3 more authors
Applied Health Economics and Health Policy. IF = 3.686, ABDC = C , 2022
@article{jiang2022denosumab,author={Jiang, Yawen and Jiang, Shan and Li, Limin and Shi, Si and Li, Mincai and Si, Lei},title={Cost Effectiveness of Denosumab for Secondary Prevention of Osteoporotic Fractures Among Postmenopausal Women in China: An Individual-Level Simulation Analysis},journal={Applied Health Economics and Health Policy},year={2022},doi={10.1007/s40258-022-00784-3},}
Difficulty and help with activities of daily living among older adults living alone during the COVID-19 pandemic: a multi-country population-based study
Shanquan Chen, Linda Jones, Shan Jiang, and 1 more author
Older adults who live alone and have difficulties in activities of daily living (ADLs) may have been more vulnerable during the COVID-19 pandemic. However, little is known about pandemic-related changes in ADL assistance (such as home care, domiciliary care) and its international variation. We examined international patterns and changes in provision of ADL assistance, and related these to country-level measures including national income and health service expenditure. We analysed data covering 29 countries from three longitudinal cohort studies (Health and Retirement Study, English Longitudinal Study of Aging, and Survey of Health, Ageing and Retirement in Europe). Eligible people were aged ≥50 years and living alone. Outcomes included ADL difficulty status (assessed via six basic ADLs and five instrumental ADLs) and receipt of ADL assistance. Wealth-related inequality and need-related inequity in ADL assistance were measured using Erreygers’ corrected concentration index (ECI). Correlations were estimated between prevalence/inequality/inequity in ADL assistance and national health-related indicators. We hypothesized these measures would be associated with health system factors such as affordability and availability of ADL assistance, as well as active ageing awareness. During COVID-19, 18.4% of older adults living alone reported ADL difficulties (ranging from 8.8% in Switzerland to 29.2% in the USA) and 56.8% of those reporting difficulties received ADL assistance (ranging from 38.7% in the UK to 79.8% in Lithuania). Females were more likely to receive ADL assistance than males in 16/29 countries; the sex gap increased further during the pandemic. Wealth-related ECIs indicated socioeconomic equality in ADL assistance within 24/39 countries before the pandemic, and significant favouring of the less wealthy in 18/29 countries during the pandemic. Needs-related ECIs indicated less equity in assistance with ADLs during the pandemic than before. Our hypotheses on the association between ADL provision measures and health system factors were confirmed before COVID-19, but unexpectedly disconfirmed during COVID-19. This study revealed an unequal (and in some countries, partly needs-mismatched) response from countries to older adults living alone during the COVID-19 pandemic. The findings might inform future research about, and policies for, older adults living alone, particularly regarding social protection responses during crises.
@article{chen2022adl,author={Chen, Shanquan and Jones, Linda and Jiang, Shan and Cardinal, Rudolf},title={Difficulty and help with activities of daily living among older adults living alone during the COVID-19 pandemic: a multi-country population-based study},journal={BMC Geriatrics},year={2022},doi={10.1186/s12877-022-02799-w},}
Patient Preferences in Targeted Pharmacotherapy for Cancers: A Systematic Review of Discrete Choice Experiments
Shan Jiang, Ru Ren, Yuanyuan Gu, and 3 more authors
PharmacoEconomics. IF = 4.4, ABDC = A. Selected among the Best 20 Publications at MUCHE (2021–2025) , 2022
@article{jiang2022targeteddce,author={Jiang, Shan and Ren, Ru and Gu, Yuanyuan and Jeet, Varinder and Liu, Ping and Li, Shunping},title={Patient Preferences in Targeted Pharmacotherapy for Cancers: A Systematic Review of Discrete Choice Experiments},journal={PharmacoEconomics},year={2022},doi={10.1007/s40273-022-01198-8},}
A scoping review of global guidelines for the disclosure of secondary genomic findings to inform the establishment of guidelines in China
@article{jiang2022scopingsf,author={Jiang, Shan},title={A scoping review of global guidelines for the disclosure of secondary genomic findings to inform the establishment of guidelines in China},journal={China CDC Weekly},year={2022},doi={10.46234/ccdcw2022.146},}
Incorporating Productivity Loss in Health Economic Evaluations: A Review of Guidelines and Practices Worldwide and A Research Agenda for China
Shan Jiang, Yitong Wang, Lei Si, and 5 more authors
Productivity loss may contribute to a large proportion of costs of health conditions in an economic evaluation from a societal perspective, but there is currently a lack of methodological consensus on how productivity loss should be measured and valued. Despite the research progress surrounding this issue in other countries, it has been rarely discussed in China. We reviewed the official guidelines on economic evaluations in different countries and regions and screened the literature to summarise the extent to which productivity loss was incorporated in economic evaluations and the underlying methodological challenges. A total of 48 guidelines from 46 countries/regions were included. Although 32 (67%) guidelines recommend excluding productivity loss in the base case analysis, 23 (48%) guidelines recommend including productivity loss in the base case or additional analyses. Through a review of systematic reviews and the economic evaluation studies included in these reviews, we found that the average probability of incorporating productivity loss in an economic evaluation was 10.2%. Among the economic evaluations (n=478) that explicitly considered productivity loss, most (n=455) considered losses from paid work, while only a few studies (n=23) considered unpaid work losses. Recognising the existing methodological challenges and the specific context of China, we proposed a practical research agenda and a disease list for progress on this topic, including the development of the disease list comprehensively consisting of health conditions where the productivity loss should be incorporated into economic evaluations. An increasing number of guidelines recommend the inclusion of productivity loss in the base case or additional analyses of economic evaluation. We optimistically expect that more Chinese researchers notice the importance of incorporating productivity loss in economic evaluations and anticipate guidelines that may be suitable for Chinese practitioners and decision-makers that facilitate the advancement of research on productivity loss measurement and valuation.
@article{jiang2022productivity,author={Jiang, Shan and Wang, Yitong and Si, Lei and Zang, Xiao and Gu, Yuanyuan and Jiang, Yawen and Liu, Gordon G. and Wu, Jing},title={Incorporating Productivity Loss in Health Economic Evaluations: A Review of Guidelines and Practices Worldwide and A Research Agenda for China},journal={BMJ Global Health},year={2022},doi={10.1136/bmjgh-2022-009777},}
An Analysis of Life-Year Lost Due to COVID-19 — 34 Countries, December 2019–March 2021
Shan Jiang, Cai Dan, Daqin Chen, and 1 more author
@article{jiang2022lyl,author={Jiang, Shan and Dan, Cai and Chen, Daqin and Jiang, Yawen},title={An Analysis of Life-Year Lost Due to COVID-19 — 34 Countries, December 2019–March 2021},journal={China CDC Weekly},year={2022},doi={10.46234/ccdcw2022.109},}
2021
Economic Evaluation of Remdesivir for the Treatment of Severe COVID-19 Patients in China under Different Scenarios
Yawen Jiang, Dan Cai, Daqin Chen, and 3 more authors
British Journal of Clinical Pharmacology. IF = 3.4 , 2021
The present study aimed to evaluate the cost‐effectiveness of the 5‐day remdesivir regimen compared with standard of care among severe COVID‐19 patients in China, the evidence on which is essential to inform the necessity of securing access to remdesivir. A dynamic transmission model that extended the susceptible–exposed–infected–recovered framework by incorporating asymptomatic, presymptomatic and waiting‐to‐be‐diagnosed patients was constructed to conduct the cost‐effectiveness analysis from the healthcare system perspective. To estimate epidemic parameters, the model was first calibrated to the observed epidemic curve in Wuhan from 23 January to 19 March 2020. Following the calibration, the infected compartment was replaced by 3 severity‐defined health states to reflect differential costs and quality of life associated with disease gravity. Costs and quality‐adjusted life year (QALY) outcomes of 9 million simulated people were accrued across time to evaluate the incremental cost‐effectiveness ratio of remdesivir. As robustness checks, an alternative modelling technique using decision tree, additional epidemic scenarios representing different epidemic intensities, and 1‐way parameter variations were also analysed. Remdesivir treatment cost CN¥97.93 million more than standard of care. Also, the net QALY gain from 5‐day remdesivir treatment was 6947 QALYs. As such, the incremental cost‐effectiveness ratio was CN¥14 098/QALY, substantially lower than the gross domestic product per capita threshold. The peak daily number of severe cases was 19% lower in the remdesivir treatment strategy. Overall, results were robust in alternative scenarios and sensitivity analyses. Given the cost‐effectiveness profile, access to remdesivir for severe COVID‐19 patients in China should be considered.
@article{jiang2021remdesivir,author={Jiang, Yawen and Cai, Dan and Chen, Daqin and Jiang, Shan and Si, Lei and Wu, Jing},title={Economic Evaluation of Remdesivir for the Treatment of Severe COVID-19 Patients in China under Different Scenarios},journal={British Journal of Clinical Pharmacology},year={2021},doi={10.1111/bcp.14860},}
Incorporating future unrelated medical costs in cost-effectiveness analysis in China
Shan Jiang, Yitong Wang, Junwen Zhou, and 3 more authors
The occurrence of future unrelated medical costs is a direct consequence of life-prolonging interventions, but most pharmacoeconomic guidelines recommend the exclusion of these costs. The Chinese guidelines were updated in 2020, taking an exclusion approach for the future unrelated medical cost. We notice the research surrounding this issue continues in other countries and leads to an inclusion recommendation in some guidelines. Meanwhile, this issue has not been discussed in China, reflecting an urgent need for extensive research on its impact. We reviewed the theoretical and practical studies surrounding the inclusion of future unrelated medical costs, summarised the landscape of guidelines in other jurisdictions. We found that the inclusion would increase the internal and external consistency of economic evaluation and the comparability of results between different jurisdictions. However, more research is needed surrounding this issue. We proposed a future research agenda to inform the update of Chinese guidelines. We recommend research on individual-level healthcare reimbursement data and end-of-life costs from hospital administrative data to generate the age-specific, sex-specific and condition-specific costs. We also recommend establishing a formal process to evaluate the ethical and economic impact of including future unrelated medical costs and adjust the threshold accordingly in the guidelines.
@article{jiang2021futurecosts,author={Jiang, Shan and Wang, Yitong and Zhou, Junwen and Jiang, Yawen and Liu, Gordon G. and Wu, Jing},title={Incorporating future unrelated medical costs in cost-effectiveness analysis in China},journal={BMJ Global Health},year={2021},doi={10.1136/bmjgh-2021-006655},}
Pharmacoeconomics of Obesity in China: A Scoping Review
Zhuo Chen, Shan Jiang, Youfa Wang, and 4 more authors
Expert Review of Pharmacoeconomics and Outcomes Research. IF = 2.3 , 2021
@article{chen2021obesity,author={Chen, Zhuo and Jiang, Shan and Wang, Youfa and Khan, M. Mahmud and Zhang, Donglan and Rajbhandari-Thapa, Janani and Li, Li},title={Pharmacoeconomics of Obesity in China: A Scoping Review},journal={Expert Review of Pharmacoeconomics and Outcomes Research},year={2021},doi={10.1080/14737167.2021.1882306},}
Do rural residents in China understand EQ-5D-5L as intended? Evidence from a qualitative study
Fan Yang, Shan Jiang, Xiaoning He, and 4 more authors
@article{yang2021eq5d,author={Yang, Fan and Jiang, Shan and He, Xiaoning and Li, Hongchao and Wu, Hongyan and Zhang, Tiantian and Wu, Jing},title={Do rural residents in China understand EQ-5D-5L as intended? Evidence from a qualitative study},journal={PharmacoEconomics Open},year={2021},doi={10.1007/s41669-020-00212-z},}
Effectiveness of Remdesivir for the Treatment of Hospitalized COVID-19 Persons: A Network Meta-analysis
Yawen Jiang, Daqin Chen, Dan Cai, and 2 more authors
Several randomized clinical trials (RCTs) that investigated the effectiveness of remdesivir for the treatment of coronavirus disease‐2019 (COVID‐19) have generated inconsistent evidence. The present study aimed to synthesize available RCT evidence using network meta‐analyses (NMAs). Both blinded and open‐label RCTs in PubMed database from inception to 7 June 2020 that contained “remdesivir”, “Covid‐19”, and “trial” in the abstracts conducted on hospitalized COVID‐19 persons were identified and screened. The studies must have at least one remdesivir arm and evaluated one of the pre‐specified outcomes. The outcomes were clinical improvement between days 10 to 15 after randomization and clinical recovery during the follow‐up period. The identified literature was supplemented with relatively recent studies that were known to the researchers if not already included. Frequentist NMAs with random effects were conducted. Both 10‐day and 5‐day remdesivir regimens were associated with higher odds of clinical improvement (odds ratio [OR] of 10‐day regimen: 1.35, 95% confidence interval [CI], 1.09‐1.67); OR of 5‐day regimen: 1.81, 95% CI, 1.32‐2.45, and higher probabilities of clinical recovery (relative risk [RR] of 10‐day regimen: 1.24, 95% CI, 1.07‐1.43; RR of 5‐day regimen: 1.47, 95% CI, 1.16‐1.87 compared with placebo. Remdesivir may have clinical benefits among hospitalized COVID‐19 persons.
@article{jiang2021nma,author={Jiang, Yawen and Chen, Daqin and Cai, Dan and Yi, Yao and Jiang, Shan},title={Effectiveness of Remdesivir for the Treatment of Hospitalized COVID-19 Persons: A Network Meta-analysis},journal={Journal of Medical Virology},year={2021},doi={10.1002/jmv.26443},}
Estimation of the Cost-Effective Threshold of a Quality-Adjusted Life Year in China Based on the Value of Statistical Life
Dan Cai, Si Shi, Shan Jiang, and 3 more authors
European Journal of Health Economics. IF = 4.4, ABDC = A , 2021
Cost-effective threshold (CET) is essential for health technology assessment and decision-making based on health economic evaluations. Recently, it has been argued that the commonly used once and three times of gross domestic product (GDP) per capita CETs of a quality-adjusted life year (QALY) are not necessarily empirically supported in all countries. Therefore, we aimed to estimate the CET of a QALY as times of GDP per capita in China, of which the reimbursement coverage decisions are increasingly engaging economic evaluations. Estimates on the value of statistical life (VSL) in China were identified from several studies in the literature and converted to times of GDP per capita, the weighted average of which was used for subsequent calculation. By pooling data on population mortality, health utility, and age distribution, we estimated the value of a statistical QALY (VSQ) from VSL using an established mathematical process, which represented the theoretical upper bound of CET. The corresponding point estimate and theoretical lower bound were obtained using their numerical relationships with the upper bound. Scenarios analyses were also conducted. The estimated CET, its upper bound, and its lower bound were 1.45, 2.90, and 1.16 times of GDP per capita in China, respectively. In different scenarios, the estimated CET varied but was greater than once GDP per capita in most cases. As such, the CET of a QALY in China is close to 1.5 times of GDP per capita, which should be benchmarked for future ICER-based coverage decisions.
@article{cai2021threshold,author={Cai, Dan and Shi, Si and Jiang, Shan and Si, Lei and Wu, Jing and Jiang, Yawen},title={Estimation of the Cost-Effective Threshold of a Quality-Adjusted Life Year in China Based on the Value of Statistical Life},journal={European Journal of Health Economics},year={2021},doi={10.1007/s10198-021-01384-z},}
A Systematic Review of Measuring the Preference for Targeted Therapy in Cancer Patients by Discrete Choice Experiment (Chinese)
Ping Liu, Shan Jiang, and Shun-ping Li
Chinese Journal of Cancer Prevention and Treatment. CNKI Core Journal , 2021
@article{liu2021targetedreview,author={Liu, Ping and Jiang, Shan and Li, Shun-ping},title={A Systematic Review of Measuring the Preference for Targeted Therapy in Cancer Patients by Discrete Choice Experiment (Chinese)},journal={Chinese Journal of Cancer Prevention and Treatment},year={2021},doi={10.16073/j.cnki.cjcpt.2021.04.13},}
2020
Preferences of Older Patients with Chronic Diseases for Medication Review Services in Shanxi, China: Results from a Discrete Choice Experiment
@article{lu2020medreview,author={Lu, Jiao and Jiang, Shan},title={Preferences of Older Patients with Chronic Diseases for Medication Review Services in Shanxi, China: Results from a Discrete Choice Experiment},journal={Value in Health Regional Issues (Abstract)},year={2020},doi={10.1016/j.vhri.2020.07.460},}
Using Instant Messenger to Recruit Research Participants in Medical Decision Making: Does WeChat Provide an Alternative Solution?
@article{jiang2020wechat,author={Jiang, Shan and Lu, Jiao},title={Using Instant Messenger to Recruit Research Participants in Medical Decision Making: Does WeChat Provide an Alternative Solution?},journal={Value in Health (Abstract)},year={2020},doi={10.1016/j.jval.2020.04.1151},}
Best-Worst Scaling in Health Economics in China: Past, Present, and Future
@article{jiang2020bws,author={Jiang, Shan and Lu, Jiao},title={Best-Worst Scaling in Health Economics in China: Past, Present, and Future},journal={Value in Health (Abstract)},year={2020},doi={10.1016/j.jval.2020.04.1031},}
The Application of Synthetic Control Method in Health Policy Assessment (Chinese)
Wenxi Tang, Mengran Zhang, Wenfei Ding, and 2 more authors
Chinese Health Economics. CNKI Core Journal , 2020
@article{tang2020synthetic,author={Tang, Wenxi and Zhang, Mengran and Ding, Wenfei and Jiang, Shan and Zang, Xiao},title={The Application of Synthetic Control Method in Health Policy Assessment (Chinese)},journal={Chinese Health Economics},year={2020},doi={10.7664/CHE20200404},}
Health-Care Practitioners’ Preferences for the Return of Secondary Findings from Next Generation Sequencing: A Discrete-Choice Experiment
Shan Jiang, Aslam Anis, Ian Cromwell, and 6 more authors
@article{jiang2020gim,author={Jiang, Shan and Anis, Aslam and Cromwell, Ian and Mohammadi, Tima and Shrader, Kasmintan and Lucas, Janet and Armour, Christine and Bombard, Yvonne and Regier, Dean},title={Health-Care Practitioners' Preferences for the Return of Secondary Findings from Next Generation Sequencing: A Discrete-Choice Experiment},journal={Genetics in Medicine},year={2020},doi={10.1038/s41436-020-0927-x},}
Addressing methodological and ethical issues in practicing health economic evaluation in China
Shan Jiang, Zhuo Chen, Jing Wu, and 2 more authors
@article{jiang2020methods,author={Jiang, Shan and Chen, Zhuo and Wu, Jing and Zang, Xiao and Jiang, Yawen},title={Addressing methodological and ethical issues in practicing health economic evaluation in China},journal={Journal of Global Health},year={2020},doi={10.7189/jogh.10.020322},}
Tertiary Hospitals or Community Clinics? An Enquiry into the Factors Affecting Patients’ Choice for Healthcare Facilities in Urban China
Shan Jiang, Yuanyuan Gu, Fan Yang, and 4 more authors
@article{jiang2020facilities,author={Jiang, Shan and Gu, Yuanyuan and Yang, Fan and Wang, Hui and Wu, Tao and Cutler, Henry and Zhang, Lufa},title={Tertiary Hospitals or Community Clinics? An Enquiry into the Factors Affecting Patients' Choice for Healthcare Facilities in Urban China},journal={China Economic Review},year={2020},doi={10.1016/j.chieco.2020.101538},}
Burden of cardiovascular diseases associated with fine particulate matter in Beijing, China: an economic modelling study
To evaluate the economic and humanistic burden associated with cardiovascular diseases that were attributable to fine particulate matter (≤ 2.5 μg/m3 in aerodynamic diameter; PM2.5) in Beijing. This study used a health economic modelling approach to compare the actual annual average PM2.5 concentration with the PM2.5 concentration limit (35 µg/m3) as defined by the Chinese Ambient Air Quality Standard in terms of cardiovascular disease outcomes in Beijing adult population. The outcomes included medical costs, quality-adjusted life-years (QALYs) and net monetary loss (NML). Beijing annual average PM2.5 concentration was around 105 µg/m3 during 2013–2015. Therefore, we estimated the differences in cardiovascular outcomes of Beijing adults between exposure to the PM2.5 concentration of 105 µg/m3 and exposure to the concentration of 35 µg/m3. According to WHO estimates, the hazard ratios of coronary heart disease and stroke associated with the increase of PM2.5 concentration from 35 to 105 µg/m3 were 1.15 and 1.29, respectively. The total 1-year excess medical costs of cardiovascular diseases associated with PM2.5 pollution in Beijing was US147.9 million and the total 1-year QALY loss was 92 574 in 2015, amounting to an NML of US2281.8 million. The expected lifetime incremental costs for a male Beijing adult and a female Beijing adult were US237 and US163, the corresponding QALY loss was 0.14 and 0.12, and the corresponding NML was US3514 and US2935. PM2.5-related cardiovascular diseases imposed high economic and QALY burden on Beijing society. Continuous and intensive investment on reducing PM2.5 concentration is warranted even when only cardiovascular benefits are considered.
@article{jiang2020pm25,author={Jiang, Yawen and Jiang, Shan and Ni, Weiyi},title={Burden of cardiovascular diseases associated with fine particulate matter in Beijing, China: an economic modelling study},journal={BMJ Global Health},year={2020},doi={10.1136/bmjgh-2020-003160},}
The cost-effectiveness of conducting three versus two reverse transcription-polymerase chain reaction tests for diagnosing and discharging people with COVID-19: evidence from the epidemic in Wuhan, China
Yawen Jiang, Dan Cai, Daqin Chen, and 1 more author
The objectives were to evaluate the effectiveness of conducting three versus two reverse transcription-PCR (RT-PCR) tests for diagnosing and discharging people with COVID-19 with regard to public health and clinical impacts by incorporating asymptomatic and presymptomatic infection and to compare the medical costs associated with the two strategies. A model that consisted of six compartments was built. The compartments were the susceptible (S), the asymptomatic infective (A), the presymptomatic infective (L), the symptomatic infective (I), the recovered (R), and the deceased (D). The A, L and I classes were infective states. To construct the model, several parameters were set as fixed using existing evidence and the rest of the parameters were estimated by fitting the model to a smoothed curve of the cumulative confirmed cases in Wuhan from 24 January 2020 to 6 March 2020. Input data about the cost-effectiveness analysis were retrieved from the literature. Conducting RT-PCR tests three times for diagnosing and discharging people with COVID-19 reduced the estimated total number of symptomatic cases to 45 013 from 51 144 in the two-test strategy over 43 days. The former strategy also led to 850.1 quality-adjusted life years (QALYs) of health gain and a net healthcare expenditure saving of CN¥49.1 million. About 100.7 QALYs of the health gain were attributable to quality-adjusted life day difference between the strategies during the analytic period and 749.4 QALYs were attributable to years of life saved. More accurate strategies and methods of testing for the control of COVID-19 may reduce both the number of infections and the total medical costs. Increasing the number of tests should be considered in regions with relatively severe epidemics when existing tests have moderate sensitivity.
@article{jiang2020rtpcr,author={Jiang, Yawen and Cai, Dan and Chen, Daqin and Jiang, Shan},title={The cost-effectiveness of conducting three versus two reverse transcription-polymerase chain reaction tests for diagnosing and discharging people with COVID-19: evidence from the epidemic in Wuhan, China},journal={BMJ Global Health},year={2020},doi={10.1136/bmjgh-2020-002690},}
Collective Pharmaceutical Procurement in China May Have Unintended Consequences
@article{jiang2020procurement,author={Jiang, Shan and Chen, Zhuo and Wu, Tao and Wang, Hui},title={Collective Pharmaceutical Procurement in China May Have Unintended Consequences},journal={Journal of Global Health},year={2020},doi={10.7189/jogh.10.010314},}
Identifying Options of Best Value: Use of Economic Evaluation in Public Health
Zhuo Chen, Lei Zhou, Shan Jiang, and 1 more author
@article{chen2020options,author={Chen, Zhuo and Zhou, Lei and Jiang, Shan and Haddix, Anne},title={Identifying Options of Best Value: Use of Economic Evaluation in Public Health},journal={China CDC Weekly},year={2020},doi={10.46234/ccdcw2020.021},}
2019
Impact of Public Hospital Pricing Reform on Medical Expenditure Structure in Jiangsu, China: A Synthetic Control Analysis
Xiao Zang, Mengran Zhang, Shihao Wei, and 2 more authors
@article{zang2019pricing,author={Zang, Xiao and Zhang, Mengran and Wei, Shihao and Tang, Wenxi and Jiang, Shan},title={Impact of Public Hospital Pricing Reform on Medical Expenditure Structure in Jiangsu, China: A Synthetic Control Analysis},journal={BMC Health Services Research},year={2019},doi={10.1186/s12913-019-4357-x},}
2017
Warm Needling Acupuncture and Medicinal Cake-separated Moxibustion for Hyperlipidemia: Study Protocol for a Randomized Controlled Trial
Mailan Liu, Qian Zhang, Shan Jiang, and 1 more author
@article{liu2017acupuncture,author={Liu, Mailan and Zhang, Qian and Jiang, Shan and others},title={Warm Needling Acupuncture and Medicinal Cake-separated Moxibustion for Hyperlipidemia: Study Protocol for a Randomized Controlled Trial},journal={Trials},year={2017},doi={10.1186/s13063-017-2029-x},}
Human papillomavirus and oral squamous cell carcinoma: A review of HPV-positive oral squamous cell carcinoma and possible strategies for future
@article{jiang2017hpv,author={Jiang, Shan and Dong, Yong},title={Human papillomavirus and oral squamous cell carcinoma: A review of HPV-positive oral squamous cell carcinoma and possible strategies for future},journal={Current Problems in Cancer},year={2017},doi={10.1016/j.currproblcancer.2017.02.006},}
The role of education in colorectal cancer screening participation: Updated evidence from Canadian Community Health Survey (2011-2012)
Shan Jiang and Hector Velasquez-Garcia
Cancer Treatment and Research Communications, 2017
@article{jiang2017crc,author={Jiang, Shan and Velasquez-Garcia, Hector},title={The role of education in colorectal cancer screening participation: Updated evidence from Canadian Community Health Survey (2011-2012)},journal={Cancer Treatment and Research Communications},year={2017},doi={10.1016/j.ctarc.2016.10.001},}
2016
Chinese Health System Development From 1949 To 2015: A Systematic Review
Shan Jiang, Yalu Zhang, Jingpei Long, and 1 more author
@article{jiang2016system,author={Jiang, Shan and Zhang, Yalu and Long, Jingpei and Dong, Yong},title={Chinese Health System Development From 1949 To 2015: A Systematic Review},journal={Value in Health (Abstract)},year={2016},doi={10.1016/j.jval.2016.03.747},}
Health Policy Review: Regional Reforms in Hospitals, Medical Personal System, and Mode of Payment in China
Yalu Zhang, Shan Jiang, Jingpei Long, and 1 more author
@article{zhang2016policyreview,author={Zhang, Yalu and Jiang, Shan and Long, Jingpei and Dong, Yong},title={Health Policy Review: Regional Reforms in Hospitals, Medical Personal System, and Mode of Payment in China},journal={Value in Health (Abstract)},year={2016},doi={10.1016/j.jval.2016.03.1947},}