부산대학교 도서관

Purpose As classical health technology assessment models fail to predict the complexities of related impacts, the application of modeling techniques such as systems dynamics simulation (SD) is essential. This study aimed to develop an SD model to predict the outcomes of access to a new medicine in Iran. Methods This study extracted the important and influential variables in providing access to new pharmaceutical technologies by comprehensively reviewing previous research and combining the technical knowledge of experts in this field. The variables were incorporated into the systems thinking framework and modeled using dynamic systems tools, followed by simulation and testing in VENSIM. The model was piloted for deferoxamine and deferasirox in thalassemia. Various tests were used to evaluate the validity and reliability of the model. The model was designed for a ten-year horizon (2018-2028) for medicines selected as the pilot. Results The variables extracted from the panel of experts encompassed the primary and short-term impacts of access to newly emerged medicine and long-term impacts regarding the economy, health, and society. After modeling, the leverage points presented for the problem with the greatest impact or effectiveness in access to new medicine included the policy determining the amount of medicine supply, the import and production of medicine, the prevalence and incidence of disease, insurance coverage, and treatment adherence. Conclusion The SD models allow the researchers to evaluate the efficiency and health outcomes of a new pharmaceutical more precisely in the health system in Iran. Graphical abstract Keywords: New medicine, Dynamic modeling, Health technology assessment, Horizon scanning
Author(s): Zahra Goudarzi[sup.1], Milad Ahmadi Marzaleh[sup.2], Shekoufeh Nikfar[sup.3], Abbas Kebriaeezadeh[sup.3], Reza Yousefi Zenouz[sup.4], Akbar Abdollahiasl[sup.3] and Mojtaba Nouhi[sup.5] Introduction The decision-makers in the health system consistently suffer from indecisiveness in [...]